Manejo quirúrgico de las hernias de la pared abdominal en contexto de urgencia: revisión bibliográfica y recomendaciones prácticas

Abstract

Background

Abdominal wall hernias are a frequent cause of emergency surgical consultation. Timely management is essential to reduce complications, morbidity, mortality, and healthcare costs.

Objective

To review the current evidence regarding the surgical management of ventral, inguinal, and femoral hernias in emergency settings, and to provide practical recommendations applicable to routine hospital practice.

Methods

A narrative review of the literature was performed using PubMed, Scopus, and Cochrane databases (2018–2025), complemented by institutional documents and protocols. HerniaSurge and WSES guidelines, recent systematic reviews, and relevant studies on emergency abdominal wall hernia repair were included.

Results

Laparoscopic repair is safe and feasible in selected patients with incarcerated or strangulated hernias, allowing assessment of bowel viability and reducing overall postoperative morbidity. Mesh repair is acceptable in clean-contaminated surgical fields, whereas its use should be avoided in cases of gross contamination. Female sex, femoral hernia type, and larger defect diameter are associated with an increased risk of incarceration.

Conclusions

Management must consider hemodynamic status, contamination degree, and surgical expertise. Institutional protocols, early surgical management, and training in minimally invasive techniques are essential to improve outcomes in emergency abdominal wall hernia repair.

essed. A multidisciplinary approach is essential to optimize diagnosis and treatment.