Clinical spectrum of obstructed inguinal hernia and its clinical outcome

Authors

  • Rabin Pratap Shah Department of General Surgery, Janaki Medical College & Teaching Hospital, Janakpur, Nepal
  • Shashi Shekhar Adhikari Department of General Surgery, Janaki Medical College & Teaching Hospital, Janakpur, Nepal
  • Khagendra Gautam Department of General Surgery, Janaki Medical College & Teaching Hospital, Janakpur, Nepal

DOI:

https://doi.org/10.18203/2349-2902.isj20241735

Keywords:

Hernia, Prognosis, Mortality, Outcome, Swelling

Abstract

Background: Obstructed inguinal hernia is an emergency surgical condition the world over. The study was aimed to study the clinical spectrum of obstructed inguinal hernia and its management.

Methods: This cross-sectional study was conducted at Department of General Surgery, Janaki Medical College and Teaching Hospital, Janakpur, Nepal. In this study, we included all cases, aged above 12 years, with obstructed inguinal hernia admitted in our department. Excluded cases were patients suffering from comorbid conditions predisposing to development of groin hernia and those who were unfit to undergo surgical intervention.

Results: During the study duration, we included 60 consecutive patients fulfilling the study criteria. Mean age of the patients was 49.5±6.24 years, ranging from 12 to 78 years. The most common presenting symptoms were pain and irreducible swelling, observed in all patients. The onset of symptoms was less than 6 hours in 58% of the patients. The most common contents of the hernial sac was small intestine (47%). Herniorrhaphy was done in 73%. In our study, post-operatively there were wound infections in 5% cases, seroma in 4%, post-operative hematoma in 3% and paralytic ileus was present in one case. At 30 days post-operatively, one cases died (2%).

Conclusions: Obstructed inguinal hernias continue to be a source of morbidity and mortality in Nepal. Wound infection rate was 6% and one case expired in the 30 day follow up period.

References

Rosse C. Hollinshead’s textbook of anatomy. Philadelphia: Lippincott-Raven; 1997: 621-637.

Skadalakis J. Hernia: surgical anatomy and technique. New York: McGraw-Hill; 1989: 54-97.

Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM. Open mesh versus non-mesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev. 2002;(4):CD002197.

Quintas ML, Rodrigues CJ, Yoo JH, Rodrigues Junior AJ. Age related changes in the elastic fiber system of the interfoveolar ligament. Rev Hosp Clin Fac Med Sao Paulo. 2000;55:83-6.

Sulaiman J, Sahayam SJ, Anandan H. A Study of Incidence of Different Types of Groin Hernias in Adults. Int J Sci Stud. 2018;5(10):87-90.

Oida T, Kawasaki A, Mimatsu K, Kano H, Kuboi Y, Fukino N, et al. Mesh vs. non-mesh repair for inguinal hernias in emergency operations. Hepatogastroenterol. 2012;59(119):2112-4.

Andrews NJ. Presentation and outcome of strangulated external hernia in a district general hospital. Br J Surg. 1981;68:329-332.

Oishi SN, Page CP, Schwesinger WH. Complicated presentations of groin hernias. Am J Surg. 1991;162:568-71.

Kulah B, Kulacoglu IH, Oruc MT, Duzgun AP, Moran M, Ozmen MM et al. Presentation and outcome of incarcerated external hernias in adults. Am J Surg. 2001;181:101-4.

Padmasree G. A clinical study on obstructed inguinal hernia: a descriptive study on 53 cases. Int Surg J. 2019;6:1965-71.

Prasad D, Patel Y. A study of outcome and complications of emergency inguinal hernias repair. Int Surg J. 2020;7:419-22.

Dasaratu S. A study of outcome and complications of emergency inguinal hernia repair at tertiary referral center. MedPulse Int J Surg. 2021;17(2):27-31.

Faridi SH, Aslam M, Ali WM, Siddiqui B, Ahmed NM. A Study of Mesh repair in emergency inguinal hernia surgery. Surg Chron. 2016;21(1):17-20.

Koning GG, Keus F, Koeslag L. Randomized clinical trial of chronic pain after the transinguinal preperitoneal technique compared with Lichtenstein's method for inguinal hernia repair. Br J Surg. 2012;99:1365-73.

A Grant EU. Hernia Trialists Collaboration. Mesh compared with non-mesh methods of open groin hernia repair: systemic review of randomized controlled trails. Br J of Surg. 2000;87:854-9.

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Published

2024-06-27

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Original Research Articles