Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)

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.

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

BMC Surgery ◽

10.1186/s12893-015-0052-y ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 29

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

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

The Surgery Journal ◽

10.1055/s-0040-1722744 ◽

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.

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

Revista de Chimie ◽

10.37358/rc.18.6.6359 ◽

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.

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Hernias in the Emergency Department

10.2310/gastro.4113 ◽

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.

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Hernias in the Emergency Department

10.2310/fm.4113 ◽

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.

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