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

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.

Hernias in the Emergency Department

2017 ◽  
Author(s):  
Mary C. Westergaard ◽  
Daniel Berhanu ◽  
Ciara J. Barclay-Buchanan
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Mass ◽  
Abdominal Wall Hernia ◽  
The United States ◽  
Abdominal Hernia ◽  
Indirect Inguinal Hernia ◽  
Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia. Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

Hernias in the Emergency Department

2018 ◽  
Author(s):  
Mary C. Westergaard ◽  
Daniel Berhanu ◽  
Ciara J. Barclay-Buchanan
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Mass ◽  
Abdominal Wall Hernia ◽  
The United States ◽  
Abdominal Hernia ◽  
Indirect Inguinal Hernia ◽  
Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia.  Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

scholarly journals Pattern of abdominal wall hernia attended in Fishtail Hospital, Pokhara, Nepal

2018 ◽  
Vol 8 (2) ◽  
pp. 32-36
Author(s):  
Pradeep Ghimire ◽  
Bishowdeep Timilsina
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Wall ◽  
Striated Muscle ◽  
Abdominal Wall Hernia ◽  
Research Centre ◽  
Indirect Inguinal Hernia ◽  
Weak Spot ◽  
Demographic Profiles ◽  
Different Types ◽  
Ethical Clearance

Introduction: All hernias are caused by a combination of pressure and an opening or weakness of muscle or fascia. The pressures push an organ or tissue through the opening or weak spot. Sometimes muscle weakness is present at birth; more often it occurs later in life. Abdominal wall hernias occur only at sites at which the aponeurosis and fascia are not covered by striated muscle. The aim of the study was to know different pattern of abdominal hernias, to analyze various clonal and demographic profiles of various abdominal wall hernias presenting to the mid-western part of Nepal and to evaluate different types of operation and complication performed in hernias patients. Methods: Hospital based retrospective descriptive study performed in Fishtail Hospital and Research Centre, Pokhara Nepal in October 2012 to July 2017. Ethical clearance was taken from institute and written consent was taken from all the patients who are involved in the study. All sociodemographic data were collected and analyzed by using SPSS 20 statistical software. Results: In this study period, 492 patients of various types of hernias were operated by various methods. Most common type of hernia is indirect inguinal hernia (94.39%) and one rare spigelian hernia was also there. Right inguinal hernia was more common (58.42%). Conclusion: Inguinal Hernia was the commonest type of hernia (394, 90.3%). Among inguinal hernia right side was more common (58.42%). Among inguinal hernias, most of the hernias were found in 0-9 years (38.21%). In this study we found recurrence rate 1.4%.

scholarly journals Factors Affecting Morbidity and Mortality in Patients Who Underwent Emergency Operation for Incarcerated Abdominal Wall Hernia

2013 ◽  
Vol 97 (4) ◽  
pp. 305-309 ◽  
Author(s):  
Mesut Gul ◽  
Ibrahim Aliosmanoglu ◽  
Murat Kapan ◽  
Akin Onder ◽  
Fatih Taskesen ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Abdominal Wall ◽  
Intestinal Resection ◽  
Abdominal Wall Hernia ◽  
Emergency Operation ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Concomitant Disease ◽  
Factors Affecting ◽  
Emergency Care Units

Abstract Patients with incarcerated abdominal wall hernias (AWHs) are often encountered in emergency care units. Despite advances in anesthesia, antisepsis, antibiotic therapy, and fluid therapy, the morbidity and mortality rates for these patients remain high. Between 2006 and 2011, we retrospectively analyzed the cases of 131 patients who underwent emergency surgery for incarcerated abdominal wall hernias. Of these, there were 70 women (53.4%) and 61 men (46.6%) with an average age of 63.3 ± 17.4 years (range, 17–91 years). Morbidity was observed in 28 patients (21.4%), and the mortality rate was 2.3%. Intestinal resection, presence of concomitant disease, and general anesthesia were the independent variants that affected morbidity of patients with incarcerated abdominal wall hernias.

scholarly journals The problem of burns

2017 ◽  
Vol 4 (2) ◽  
pp. 500
Author(s):  
Bhimanagouda V. Goudar ◽  
Sidharth Agarwal ◽  
Yamanur P. Lamani ◽  
Shankar Gururaj ◽  
Veerbhadra Gouda
Keyword(s):  
Medical Care ◽  
Cause Of Death ◽  
Age Groups ◽  
Hypovolemic Shock ◽  
Total Mortality ◽  
Morbidity And Mortality ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Very High ◽  
Length Of Hospitalization

Background: Burns due to accidents are a common cause of morbidity and mortality in the Indian sub-continent. The causes being preventive, warrant a better understanding of the epidemiology to know the seriousness of the situation, implement better medical care and prevent such accidents. Aim was to study the morbidity and mortality related to percentage of burns.Methods: This is a retrospective observational study where patients admitted with burns 2013 and 2015 were evaluated. Data with respect to sex, age, percentage of burns, air-way burns, mode and cause of burns, cause of death and length of hospitalization were analyzed.Results: 65.3% of the patients were females and 34.7% males, with a male: female ratio of 0.53:1. A total mortality of 43.71% was seen. Maximum patients belonged to age group 21-40 years which also constituted 28.74% (highest) of the above total mortality. More than 50 % mortality was seen in patients with more than 41% burns. Air way burns were present in 41.31% of the cases; of which 85.51% of cases did not survive. Death due to hypovolemic shock (42.47%) was the main cause of death in the initial 4 days of admission; whereas septicemic shock (57.53%) from the 5th day onward.Conclusions: Morbidity and mortality due to burns is still very high in India, especially in young adults of age groups 21- 40 years. A higher case load for females as seen, being nearly double in in relation to males. Better fluid resuscitation regimens with adequate control of infection is the need of the hour to bring down the mortality. Female sex and more than 41% burns predicts higher mortality. Involvement of the respiratory tract, also predicts higher mortality and may be taken as a reliable indicator of the severity of burns. In the present scenario, we should stress more over the prevention of burns, to easily make available affordable and cheap medical care for the patients and to minimize post burn disability as much as possible.

Hernias in the Emergency Department

2016 ◽  
Author(s):  
Daniel Berhanu ◽  
Ciara J. Barclay-Buchanan ◽  
Mary C. Westergaard
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Mass ◽  
Abdominal Wall Hernia ◽  
The United States ◽  
Abdominal Hernia ◽  
Indirect Inguinal Hernia ◽  
Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia.  Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

scholarly journals An overview of scalp dermatoses in a tertiary care institute

2020 ◽  
Vol 6 (3) ◽  
pp. 304
Author(s):  
Ramesh Aravamuthan ◽  
Sampath Vadivelu ◽  
Shabari Arumugam ◽  
Mukesh Mithran J.
Keyword(s):  
Tertiary Care ◽  
Early Adulthood ◽  
Psychological Impact ◽  
Age Groups ◽  
Clinical History ◽  
High Rate ◽  
Female Ratio ◽  
Detailed Clinical History ◽  
Sebum Production ◽  
Scalp Dermatoses

<p class="abstract"><strong>Background:</strong> The scalp is unique among skin areas in humans, with high follicular density and high rate of sebum production which though providing thermal insulation also creates an environment conducive to superficial mycotic infections and parasitic infestations. As there is a paucity of studies on scalp dermatoses in the Indian and Western literature, a clinical study of these scalp dermatoses can unravel the common clinico-epidemiological manifestations in our population.</p><p class="abstract"><strong>Methods:</strong> This is a prospective observational study conducted for a period of 6 months. All the patients reporting to our department were evaluated for entry into the study and patients having scalp lesions were enrolled. A detailed clinical history and a thorough scalp examination were performed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The incidence of scalp dermatoses is more among adolescents and early adulthood with a male to female ratio 1.8:1. 57% of patients had lesions exclusive to scalp. Scalp was the initial site of presentation in 54.6% of cases who had generalized lesions. Itching (n=107; 53.5%) is the commonest presenting complaint. Among the scalp sites, parietal area was involved the most (73%). The most common dermatoses were psoriasis (21.5%) followed by alopecia areata (11.5%).</p><p class="abstract"><strong>Conclusions:</strong> The scalp dermatoses have significant psychological impact affecting the social profile of the patients. To the best of our knowledge, this is the first Indian study on scalp dermatoses involving all age groups which gives a precise clinical insight into scalp dermatoses.</p>

scholarly journals Abdominal wall hernia in cirrhotic patients: emergency surgery results in higher morbidity and mortality

BMC Surgery ◽  
2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Wellington Andraus ◽  
Rafael Soares Pinheiro ◽  
Quirino Lai ◽  
Luciana B.P Haddad ◽  
Lucas S Nacif ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Emergency Surgery ◽  
Abdominal Wall Hernia ◽  
Morbidity And Mortality ◽  
Cirrhotic Patients

scholarly journals Staphylococcus associated acute throat infection among children presented to a tertiary care hospital

2018 ◽  
Vol 6 (10) ◽  
pp. 3287
Author(s):  
Santhosh John Thattil ◽  
Sumitha Santhosh ◽  
Thekkuttuparambil Ananthanarayanan Ajith
Keyword(s):  
Sore Throat ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
Age Groups ◽  
Male Dominance ◽  
High Rate ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Female Ratio ◽  
Throat Infection

Background: Staphylococcus infection remains one of the most common bacterial infections that cause high rate of morbidity and mortality in children and adults. This study was aimed to find the prevalent age group and type of Staphylococcus strain among the children presented with sore throat to a tertiary care hospital.Methods: A retrospective study was done by analyzing the medical records of children (less than 10 years of age) who presented to the outpatient Paediatric department with sore throat and confirmed diagnosis of Staphylococcus. Number of coagulase negative Staphylococcus (CoNS), Staphylococcus aureus (SA), methicilline resistant (MR) and methicilline sensitive (MS) strains was analyzed in various age groups and analyzed statistically.Results: Total 129 cases of Staphylococcus infected cases were found during the period of this study. The male to female ratio was 1.86 with high rate of prevalence found among the children of age 1-3 years (39.5%) (p= 0.0031). The CoNS was found in 65/129 (50.38%) cases and all were MSSA. No MRSA infection was found during the study period. Among the total cases, 122/129 (94.57%) cases were infected with MS strains. The MR strain was found in 7/129 cases (5.4%) which was mainly in neonates. The rate of infection was less in older children (7-10-year age).Conclusions: The prevalence of Staphylococcus associated throat infection was high among the children of 1-3-year age with male dominance. The MR strain was found only 5.4% of cases and no MRSA found in this study.

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