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Current Surgical Management of the Acutely Incarcerated Ventral Hernia

  • Emergency General Surgery (J Diaz, Section Editor)
  • Published:
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Abstract

Purpose of Review

Acutely incarcerated ventral hernias represent a complex disease process in an increasing complex population. Acute incarceration can lead to strangulation and worsen morbidity and mortality. Identifying best practices based upon available evidence is paramount to optimize patient outcomes. The following is a review of the most recent literature in the management of acutely incarcerated ventral hernias.

Recent Findings

Evidence suggests early intervention (< 24 h) following incarceration mitigates the risk of strangulation and improves outcomes. The presence of ascites, an acute hernia angle, and bowel wall attenuation on computed tomography may help identify at risk patients. Fascial reinforcement with mesh is supported in hernias > 3 cm, but evidence supporting synthetic or biologic mesh use is conflicting in clean-contaminated and contaminated cases.

Summary

Acutely incarcerated ventral hernias represent a complex disease process for which high-level evidence supporting best practices is sparse, and individualized surgical care can have significant impact on patient outcomes.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, 1211 21st Ave S., Nashville, TN, 37212, USA

    Jeremy H. Levin & Oliver L. Gunter

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Correspondence to Jeremy H. Levin.

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Levin, J.H., Gunter, O.L. Current Surgical Management of the Acutely Incarcerated Ventral Hernia. Curr Surg Rep 8, 25 (2020). https://doi.org/10.1007/s40137-020-00271-5

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