Gluteal and sciatic herniae are among the rarest of abdominal hernias. The gluteal hernia passes through the greater sciatic foramen, either above or below the piriformis. The sciatic hernia passes through the lesser sciatic foramen.
These herniae must be distinguished from:
- lipoma or fibro-sarcoma beneath the gluteus maximus
- tuberculous abscess
- gluteal aneurysm
Incarceration or strangulation of the bowel diagnoses the hernia.
Repair is usually made through the abdomen. The hernia sac and contents are reduced, and the weak area closed by making a fascial flap from the superficial fascia of the piriformis muscle.