Title: A Prospetive Clinical Study on Complicated Hernias
Authors: Dr M.V.Pradeep Anand, Prof. Dr R.Ramesh, Dr K.Ravichandran, Dr Uvaraj.V
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.64
Abstract
Hernia is a common surgical problem in our country and a major health care drain. This study was carried out to determine the various types and presentations of complicated abdominal hernias, their age, sex distributions, management modalities, treatment of complicated hernias and its outcome. Fifty patients who presented to ER, Surgery department of Rajah Muthiah Medical College and Hospital during the period of October 2015 to October 2017 were selected. The majority of patients who were admitted as emergencies with complicated hernias have not sought previous medical attention or been diagnosed with the condition in the outpatient department. This observation implies that most hernias that develop complications do so within a relatively short time in the natural history of the disease. 92% of the patients in the study had primary hernia. Obstructed groin hernias turned out to be the commonest cause of small bowel obstruction in patients attending the ER. 96 patients with small bowel obstruction was admitted in the ER during the study period of whom 45 had complicated groin hernias [46%]. Complicated hernias had a peak incidence in 5th and 6th decade of life 42 %. Males had and overall increased incidence of complicated hernias 86%. And complicated femoral hernias where common in females 5 out of 6cases.76% had obstruction as the complication, 10%-strangulation and 14% had irreducible or incarcerated hernias. 70 % had constriction at the neck of the sac. 76 % had ileum as the content followed by cecum, appendix, colon and others.50 % of patients were operated by modified Bassini’s technique. 36% by meshplasty. Lotheissen procedure for 5 out of 6 cases of femoral hernias. Wound sepsis was the predominant complication.
Keywords: Inguinal hernia, femoral hernia, Epi gastric hernia, umbilical hernia. Obstruction, irreducible, strangulation.