Management of various rare and atypical hernias: experience at a tertiary care centre in central India

Authors

  • Rajiv Jain Department of General Surgery, Sri Aurobindo Medical College & PG Institute, Indore, MP, India
  • Kolla Venkatesh Department of General Surgery, Sri Aurobindo Medical College & PG Institute, Indore, MP, India

DOI:

https://doi.org/10.18203/2349-2902.isj20160216

Keywords:

Hernia, Supra pubic cystotomy, Enterocutaneous fistula, Femoral, Amayand’s

Abstract

Background: Abdominal wall hernias are most frequently encountered in surgical practice accounting for 15% - 18% of all surgical procedures. The incidence of abdominal wall hernia in different countries varies from 100 -300/100000 per year. Of which most common being the inguinal hernias and femoral hernia being the least common. Midline ventral hernias are the next common variety of abdominal wall hernia after inguinal hernia. Ours is a tertiary care hospital, medical college and PG institute in central India. Apart from routine hernias, we have managed successfully some very rare varieties and developed management protocols. Here we are providing an analysis of these unusual presentations.

Methods: This is a retrospective study in which we analyzed the data’s of hernia patients presented in our institute over the period of 7 years (2008-2014). Out of 765 patients, who were diagnosed having hernia, 680 were operated in our institute. Among these cases, we have selected 12 very rare and unusual cases which stood as diagnostic and management challenge and which were operated by a single surgeon and his team.

Results: Out of the 12 cases of atypical hernias, 11 patients underwent surgical intervention. There was no mortality. 6 patients had some postoperative complications which were managed during their Hospital stay only. After discharge, all the patients were followed at regular intervals. There was no recurrence or other complication noted in 1 year follow up. Most common post-op complication was seroma which was seen in 50% of the operated patients. Other complications were wound infection (16.66%) and wound dehiscence (8.33%).

Conclusions: The infrequent encounter with the unusual varieties of Hernias can lead to the mental bias and becomes a diagnostic challenge for the general surgeon. The purpose of publication of these rare varieties is to increase our spectrum of knowledge and to provide diagnostic and therapeutic armamentarium to deal with these difficult situations.

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Published

2016-12-13

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Original Research Articles