A clinico-epidemiological study of complicated external hernia

Abstract

Background: Abdominal wall hernias are among the most commonly encountered surgical problem. Irreducibility, obstruction, and strangulation are its commonest complications which usually presents as acute emergencies. Emergency repair of complicated hernias is associated with poor prognosis and a high rate of postoperative complications even with better care, improved anesthetic management and advanced surgicaltechniques. Methods: The aim of the study was to evaluate incidence, morbidity, and mortality in complicated hernia and to compare with it non-complicated hernia. This study was conducted in the Department of General Surgery, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, from July 2018 to December 2019 on twenty-eight patients of complicated hernia and compared with similar no of uncomplicated hernia patients. Results: The mean age of the patients was 52 years with male to female ratio of 11:3 in the complicated external hernia group. The majority of the patient (60.7%) underwent herniorrhaphy, followed by hernioplasty (14.3%). Most of the patients (89.2%) survived without any post-operative morbidity, 7.1% of them developing wound sepsis while 3.5% of patients died after surgery due to septic shock. Conclusion: Complicated external hernias occur in all age groups but are more common in older age and show preponderance in males. All patients present with irreducible swelling with no cough impulse. The indirect inguinal hernia is the most common type and herniorrhaphy is the most preferred operative procedure in the complicated hernia. Wound sepsis was the most common complication. Morbidity and mortality may be attenuated with proper surgical and post-operative management. Keywords: Abdominal wall hernia; complicated hernia; herniorrhaphy; hernia