The presence of a low lying pubic tubercle in patients with indirect inguinal hernia

Authors

  • Ashwin Aby Thomas Department of General Surgery, SRM Medical College and Hospital, Chennai, Tamil Nadu, India
  • Amrita Prasad Department of General Surgery, SRM Medical College and Hospital, Chennai, Tamil Nadu, India
  • D. S. A. Mahadevan Department of General Surgery, SRM Medical College and Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20181997

Keywords:

Anthropometric variables, Indirect inguinal hernia, Low pubic tubercle

Abstract

Background: Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Factors like chronic cough, constipation, prostatic enlargement etc. contribute to its development. Various defensive mechanisms of the inguinal canal like shutter and slit valve mechanisms help prevent its formation. In this study, a comparison has been made between the anthropometric measurements of the pelvis in patients with and without indirect inguinal hernia to look for a statistically significant difference in the position of the pubic tubercle which in turn affects the various protective mechanisms. Other measurements such as Height, Weight and interspinal distance have been included to look for positive correlations between the disease and said measurements.

Methods: This study was conducted in the General Surgery Department of SRM Hospital, Medical College and Research Centre, Kattankulathur after ethics committee clearance. It is a case control study conducted on 140 consenting patients and meeting the inclusion criteria from March 2016 to August 2017, of which 70 each were patients of indirect inguinal hernia and patients without inguinal hernia.

Results: Results developed using SPSS Software show majority of the subjects with a low lying pubic tubercle were inguinal hernia patients. There was also a positive correlation between the ratios of weight and ST length as well as Height and ST length between cases and controls.

Conclusions: It can be concluded from this study that factors such as a low lying pubic tubercle and other related anthropometric variables predispose patients to develop indirect inguinal hernia.

References

López-Cano M, Munhequete EG, Hermosilla-Pérez E, Armengol-Carrasco M, Rodríguez-Baeza A. Anthropometric characteristics of the pubic arch and proper function of the defense mechanisms against hernia formation. Hernia. 2005;9(1):56-61.

2de Carvalho CA, de Souza RR, Fernandes PM, Waksman H, Fernandes VC. The relationship between anthropometric parameters and measurements of the human inguinal region. Surg Radiologic Anat. 1987;9(4):281.

Fruchaud H. Surgical anatomy of hernias of the groin. Paris: G. Doin; 1956.

Basu I, Mukhopadhyay AK, Bhoj SS. Retrospective study on prevalence of primary and recurrent inguinal hernia and its repairs in patients admitted to a tertiary care hospital. Indian Med Gazette. 2013:203-13.

Sehgal C, Bhatia BS, Bedi PS, Mehta R. The role of low lying pubic tubercle in the development of inguinal hernia. Indian J Surg. 2000;62(4):263-5.

Rebustelo E. The shape of the pelvis and the predisposition to inguinal hernias. Journal of Surgery. 1938;4:390-404.

Pinna C. The importance of the shape of the pelvis in the genesis of the inguinal hernia. Arch Ital Chir. 1947;69(3):209-22.

Radojevic S. Surgical anatomy of the inguinal region. Anatomical bases and clinical signs of predisposition to inguinal hernia Acta Anat (Basel). 1962;50:208-63.

Ami G. The inguinal canal in humans. Lyon: These. 1964.

Zinanovic S. The anatomical basis for the high frequency of the inguinal and femoral hernia in Uganda. East Afr Med J. 1968;45(2):41-6.

Ledinsky M, Matejcić A, De Syo D, Doko M. Some structural characteristics of the inguinal region in the northern Croatia. Coll Antropol. 1998;22(2):515-24.

Munhequete EG. Study of anatomical structures related to the formation of inguinal hernias. Universitat Autònoma de Barcelona; 2003.

Harris FI, White AS. The length of the inguinal ligament in the differentiation between direct and indirect inguinal hernia. JAMA. 1937;109:1900-3.

Ajmani ML, Ajmani K. The anatomical basis for the inguinal hernia. Anat Anz. 1983;153(3):245-8.

Agrawat M, Kumar A, Sharma A, Chanchlani R. Role of low lying pubic tubercle in the development of inguinal hernia--a case control study from central India. J Evol Med Dental Sci. 2014 Apr 21;3(16):4231-7.

Stoppa R. Anthropometric characteristics of the public arch and proper function of the defense mechanisms against hernia formation. Hernia. 2005;9(4):400.

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Published

2018-05-24

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Original Research Articles