Influence of Sonographic Imaging on Patients with Anterior Abdominal Wall Hernias to Prevent Reoperations

Abstract

Background: Hernia is defined as an area of weakness or complete disruption of the body wall’s fibromuscular tissues. Structures arising from the cavity contained by the body wall can pass through, or herniate, through such a defect. The typical clinical finding is a bulged mass increasing in size when intra-abdominal pressure rises. The hernia is asymptomatic or may cause severe pain for patients. Arising of intra-abdominal pressure for each reason can generate anterior abdominal wall hernias; on the contrary, each synchronous surgically treatable intra-abdominal disease can be revealed with the same symptoms, and distinction of this disease prior to the surgery is important. Materials and methods: This study was conducted on 90 patients who were candidates for anterior abdominal wall herniorrhaphy. All patients were screened for the coexistence of intra-abdominal surgically treatable diseases using the abdominopelvic sonographic examination. According to our project, patients with a synchronous intra-abdominal illness were treated with single surgery for their hernia and surgically treatable disease. Other patients with the healthy sonographic report were only subject to herniorrhaphy. Results: The sonographic report was normal in 53 patients and abnormal (including cholelithiasis or any synchronous surgically treatable disease) in 37 patients. The study of the population using the Chi-square test to determine the need for further surgery (normal sonographic report rate) showed a statistical difference between hernia groups ( p = 0.001). In the umbilical hernia group, the need for further surgery is significantly lower than that in the other groups ( p < 0.001). Conclusions: The coexistence of intra-abdominal surgically treatable disease with anterior abdominal wall hernias and their possible recurrence due to the remaining of the intra-abdominal illness as a source for intra-abdominal cavity pressure convinced surgeons to carefully check patients for each surgically treatable intra-abdominal disease before surgery.