A clinical study on obstructed inguinal hernia: a descriptive study on 53 cases

Abstract

Background: Inguinal hernias are the common causes of surgical admissions and referral of patients from primary physicians. Although we have made a great progress in treating hernia the management of its complications has progressed only a little. The aim of study was to determine the various modes of presentation, clinical features, diagnostic and therapeutic strategies and to evaluate the post-operative outcome in obstructed hernia surgeries.Methods: After obtaining written and informed consent from the patients, cases for the study were randomly selected from patients admitted to this tertiary care hospital for surgical intervention of inguinal hernias during the period between 2015 and 2017. Cases with inguinal hernias which had signs of obstruction and inability to reduce the hernia are taken up for emergency surgical intervention within 6-8 hours.Results: 53 obstructed inguinal hernia patients were evaluated and found that, incarceration was the commonest complication seen in 92.45% of cases followed by strangulation (7.54%). Viable bowel was seen 88.67% of cases. Bowel resection and end-to-end anastomosis was done in all cases of non-viable bowel. The commonest post-operative complication encountered in the study was wound infection (9.43%) and scrotal seroma (9.43%).Conclusions: The most common content was small bowel followed by omentum (52.8% and 35.8% respectively). Wound infection and seroma were the most common complications (9.43%) and mortality was observed in two patients (3.7%) and the causes of death were sepsis and acute respiratory distress syndrome.

Pattern of inguinal hernia in Al- Basra teaching hospital: a prospective clinical study

“…Wound infection and ileus were also observed, especially in cases of strangulation and where bowel resection was performed. A similar trend was observed in other studies [21]. We observed that patients with primary hernia developed postoperative complications more than patients with recurrent hernia and this may be due to the larger number of patients with primary hernia.…”

“…These cases were managed via open reduction of the contents and the modified Bassini's repair technique. Those with obstructed (33.33%) and strangulated (6%) hernias were also managed via open surgery and resection with end-to-end anastomosis of the unhealthy bowel segments as well as via modified Bassini's repair without mesh; this is also consistent with the findings of other studies [21].…”

An observational study of clinical presentation and emergency surgical management of obstructed inguinal hernia repair

“…Femoral hernias have tight unyielding hernial rings whereas direct inguinal hernias have no well-defined hernial ring. 17 Present study found that pain and swelling were reported in all the cases, after that vomiting (58%) was the most common clinical presentation followed by abdominal distension (40%).…”

“…21 The nature of contents of a complicated hernial sac is important in two respects: the anatomical structure involved and its viability. 17 Present study found that most common content of hernial sac was small bowel (54%) followed by omentum (34% mesh could be safely and effectively used in patients with incarcerated or strangulated inguinal hernia, which significantly reduced the risk of hernia recurrence but did not increase the opportunity of surgical site infection. 14,15,19,20,37,38 Cases operated by 'resection and anastomosis' had reported 1 case with leak,…”

“…29 Shakya et al noted the mean age was 49 years. 17 Hancock et al found 66 years to be the average age. 30 McEntee et al found a peak incidence for strangulation in the eighth decade.…”