scholarly journals Abdominal Wall Hernias: An Epidemiological Profile and Surgical Experience from a Rural Medical College in Central India

2021 ◽  
Vol 07 (01) ◽  
pp. e41-e46
Author(s):  
Bharati Pandya ◽  
Tanweerul Huda ◽  
Dilip Gupta ◽  
Bhupendra Mehra ◽  
Ravinder Narang
Keyword(s):  
Abdominal Wall ◽  
Low Income ◽  
Rural Areas ◽  
Abdominal Wall Hernia ◽  
Central India ◽  
Morbidity And Mortality ◽  
Hernia Surgery ◽  
Female Ratio ◽  
Surgical Methods ◽  
Groin Hernias

Abstract Background Abdominal wall hernia is a common surgical entity worldwide with groin hernias having the most common presentation among them. They are a cause of morbidity and mortality if not addressed in time. A variety of surgical methods are available for the repair of hernias. The tension-free repair using synthetic mesh has the least recurrence and is the most accepted. Aim To describe the surgical burden and clinical profile of abdominal wall hernias as well as experiences in their management in a rural setup. Methods This was a retrospective observational study of all the cases of abdominal wall hernias presenting to various surgical divisions of Mahatma Gandhi Institute of Medical Sciences, Sevagram, during a two-year period from December 2011 to November 2013. Relevant details were collected from the hospital information statistics and patient file records and analysis of obtained data was done. Result A total of 910 out of 90,056 surgical outpatients (10.10%) seen during this period had abdominal wall hernias; 816 (89.67%) got operated. A total of 163 (20%) of 816 were operated in an emergency. Groin hernias were the most common 653 (80%), followed by incisional 82 (10%), umbilical and paraumbilical 41 (5%), epigastric 33 (4%), and rarer hernias in 8 (1%). Of 816 operations, 24 (2.9%) had recurrent hernias and 83 (10.17%) were pediatric patients. Male to female ratio was 9:1 in adults and 4:1 in children. The median age among adults was 49 years (range: 14–95 years), and among the pediatric age group, it was 7 years (range: 3 months–14 years). The majority of the adult patients were from a low-income group and presented more than 2 years after symptoms appeared. Comorbid conditions encountered were hypertension in 212 (26%), diabetes in 155 (19%), chronic airway disorders in 449 (55%), cardiac problems in 163 (20%), obesity in 10 (1.2%), and chronic renal failure and liver disorder in 82 (1%). Predisposing factors in the majority of the patients were chronic cough 449 (55%), prostatic problems in 187 (23%), chronic constipation in 163 (20%), previous surgeries in 82 (10%), obesity in 10 (1.2%), and ascites in 9 (0.1%). Hernia surgery was performed laparoscopically in 51 (6.25%) patients. Simultaneous other surgeries were performed in 130 (16%) patients. Mortality occurred in 2 (0.24%) patients operated in emergency, and chief morbidity was due to wound infection in 25 (3%) and chronic pain in 30 (3.9%) patients. Conclusion Abdominal wall hernias are common clinical entities. Although the pattern of presentation and management is similar, the challenges faced in a rural setup are due to ignorance, social inhibitions, and financial restraints, leading to delayed presentations which increase their morbidity and mortality. Health programs and surveys to increase awareness in rural areas as well as cutting down on expenses could help these patients.

scholarly journals A clinico-epidemiological study of complicated external hernia

2020 ◽  
Vol 4 (4) ◽  
pp. 01-05
Author(s):  
Lalit Kishore ◽  
◽  
Sumit Naraniya ◽  
Deepak Verma ◽  
Parul Yadav ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Anesthetic Management ◽  
Operative Procedure ◽  
Age Groups ◽  
Abdominal Wall Hernia ◽  
Morbidity And Mortality ◽  
High Rate ◽  
Indirect Inguinal Hernia ◽  
Wound Sepsis ◽  
Female Ratio

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

Clinical and Biochimical Comorbidities and Complications in Abdominal Surgery Using Synthetic Prosthetic Material

2018 ◽  
Vol 69 (6) ◽  
pp. 1519-1523
Author(s):  
Vlad Dumitru Baleanu ◽  
Danut Vasile ◽  
Alexandru Marian Goganau ◽  
Paul Ioan Tomescu ◽  
Dragos Davitoiu ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Prosthetic Material ◽  
Hernia Surgery ◽  
Tension Free ◽  
Elective Repair ◽  
Scrotal Edema ◽  
Remarkable Recovery ◽  
Risks Assessment

Hernia can be defined as an organ disorder which protrudes the wall that contains it. Synthetic material for the repair of the abdominal wall are used frequently with good results and less complications. Our research included a number of 135 patients diagnosed with inguinal hernia hospitalized and operated in Clinical County Hospital of Craiova, between 1st January 2017-31 October 2017. The purpose of our work was to identify and analyze comorbidities and complications for inguinal hernia repaired with synthetic prosthetic material. hernia repair was performed in 135 patients, 16 were women and 119 were men. Tension free meshplasty was accomplished in 131 patients with uncomplicated inguinal hernia and herniorrhaphy was successfully performed at 4 patients with complicated inguinal hernia. From our study 107 patients had a remarkable recovery without any complication. Patients who underwent tension-free hernia surgery using prosthetic mesh,short-term complications were represented by 19 patients with urinary retention, 6 surgical local infection (superficial infections) and 2 scrotal edema. Nowadays surgeons try to find the best elective repair of inguinal hernia,to be safety for the patients despite of their age and with few complications and low mortality rate. Risks assessment include general conditions and associated comorbidities of the patients. In our study we reveal the type of comorbidities which we meet. We considered that it is significant to optimize cardiopulmonary status and the other comorbidities of the patient before to repair abdominal wall hernia in order to avoid both short and long term complication.

Biological Implants in Abdominal Wall Hernia Surgery

2013 ◽  
Vol 91 (4) ◽  
pp. 217-223
Author(s):  
Manuel López Cano ◽  
Manuel Armengol Carrasco ◽  
María Teresa Quiles Pérez ◽  
María Antonia Arbós Vía
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Hernia Surgery ◽  
Biological Implants

Mesh hernioplasty in emergency repair of traumatic abdominal wall hernia following bull horn injury

2021 ◽  
Vol 14 (7) ◽  
pp. e244384
Author(s):  
Arvind Kumar Bodda ◽  
Prakash Kumar Sasmal ◽  
Swastik Mishra ◽  
Ankit Shettar
Keyword(s):  
Abdominal Wall ◽  
Rural Areas ◽  
Motor Vehicle ◽  
Abdominal Wall Hernia ◽  
Abdominal Hernia ◽  
Emergency Setting ◽  
Traumatic Abdominal Wall Hernia ◽  
Vehicle Accidents ◽  
Emergency Repair ◽  
Mesh Hernioplasty

Traumatic abdominal wall hernia (TAWH) is uncommon, mostly following motor vehicle accidents, fall from height and bullfighting. Bullhorn injury, common in rural areas, presents as either penetrating injuries to the abdomen or blunt injuries leading to internal organs injury. Rarely the bull horn injury may lead to TAWH. We report a 70-year-old female from a rural area who suffered bull horn injury to the abdomen leading to TAWH without penetrating the horn and was managed in the emergency by an open mesh hernioplasty. We suture closed the 10×5 cm size defect and reinforced it with a polypropylene mesh of 15×15 cm in the emergency setting. The patient recovered well without any complications or recurrence and doing well at 1 year of follow-up. Mesh hernioplasty can be considered a feasible and safe option in the emergency repair of traumatic abdominal hernia following bull horn injury.

Diagnosis of Mesh Infection after Abdominal Wall Hernia Surgery - Role of Radionuclide Methods

2011 ◽  
Vol 58 (110-111) ◽  
Author(s):  
Marinko Žuvela ◽  
Andrija Antić ◽  
Djordje Bajec ◽  
Dejan Radenković ◽  
Milorad Petrović ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Mesh Infection ◽  
Hernia Surgery

scholarly journals Perioperative Tablet-Based Telemonitoring After Abdominal Wall Hernia Surgery: Pilot Prospective Observational Cohort Study (Preprint)

2019 ◽  
Author(s):  
Alexander Gräfitsch ◽  
Philipp Kirchhoff ◽  
Henry Hoffmann ◽  
Ralph F Staerkle ◽  
Savas D Soysal ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Surgical Repair ◽  
Abdominal Wall Hernia ◽  
Activity Levels ◽  
Hernia Surgery ◽  
Entire Study ◽  
Median Proportion ◽  
Activity Measurements ◽  
Outpatient Settings

BACKGROUND Hernia repairs account for millions of general surgical procedures performed each year worldwide, with a notable shift to outpatient settings over the last decades. As technical possibilities such as smartphones, tablets, and different kinds of probes are becoming more and more available, such systems have been evaluated for applications in various clinical settings. However, there have been few studies conducted in the surgical field, especially in general surgery. OBJECTIVE We aimed to assess the feasibility of a tablet-based follow up to monitor activity levels after repair of abdominal wall hernias and to evaluate a possible reduction of adverse events by their earlier recognition. METHODS Patients scheduled for elective surgical repair of minor abdominal wall hernias (eg, inguinal, umbilical, or trocar hernias) were equipped with a telemonitoring system, including a tablet, pulse oximeter, and actimeter, for a monitoring phase of 7 days before and 30 days after surgery. Descriptive statistical analyses were performed. RESULTS We enrolled 16 patients with a mean overall age of 48.75 (SD 16.27) years. Preoperative activity levels were reached on postoperative day 12 with a median of 2242 (IQR 0-4578) steps after plunging on the day of surgery. The median proportion of available activity measurements over the entire study period of 38 days was 69% (IQR 56%-81%). We observed a gradual decrease in the proportion of available data for all parameters during the postoperative course. Six out of ten patients (60%) regained preoperative activity levels within 3 weeks after surgery. Overall, patients rated the usability of the system as relatively easy. CONCLUSIONS Tablet-based follow up is feasible after surgical repair of minor abdominal wall hernias, with good adherence rates during the first couple of weeks after surgery. Thus, such a system could be a useful tool to supplement or even replace traditional outpatient follow up in selected general surgical patients.

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