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Incarcerated groin hernias in adults: Presentation and outcome

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Abstract

Despite universal acceptance of the value of elective hernia repair, many patients present with incarceration or strangulation, which are associated with significant morbidity and mortality. We reviewed 147 patients who underwent emergency surgery for incarcerated groin hernias during a 10-year period in order to analyze the presentation and outcome in our practice. Median age of the patients was 70 years. There were 77 men and 70 women. Femoral hernias were seen in 77 patients and inguinal hernias in 70. Coexisting diseases were found in 82 cases (55.8%). Bowel resection was required in 19 patients (12.9%). The overall and major morbidity rates were 41.5% and 9.6%, respectively. The mortality rate was 3.4%. Longer duration of symptoms, late hospitalization, concomitant diseases, and high ASA class were found to be significant factors linked with unfavorable outcomes. Because of high morbidity and mortality associated with incarceration, elective repair of groin hernias should be done whenever possible.

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References

  1. Andrews NJ (1981) Presentation and outcome of strangulated external hernia in a district general hospital. Br J Surg 68:329–332

    CAS  PubMed  Google Scholar 

  2. Haapaniemi S, Sandblom G, Nilsson E (1999) Mortality after elective and emergency surgery for inguinal and femoral hernia. Hernia 3:205–208

    Google Scholar 

  3. Oishi SN, Page CP, Schwesinger WH (1991) Complicated presentations of groin hernias. Am J Surg 162:568–571

    CAS  PubMed  Google Scholar 

  4. Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 13:545–554

    CAS  PubMed  Google Scholar 

  5. Owens WD, Felts JA, Spitznagel EL Jr (1978) ASA Physical Status Classifications: a study of consistency of ratings. Anesthesiology 49:239–243

    CAS  PubMed  Google Scholar 

  6. Allen PI, Zager M, Goldman M (1987) Elective repair of groin hernias in the elderly. Br J Surg 74:987

    CAS  PubMed  Google Scholar 

  7. McEntee GP, O’Carroll A, Mooney B, Egan TJ, Delaney PV (1989) Timing of strangulation in adults hernias. Br J Surg 76:725–726

    CAS  PubMed  Google Scholar 

  8. Hjaltason E (1981) Incarcerated hernia. Acta Chir Scand 147:263–267

    CAS  PubMed  Google Scholar 

  9. Kulah B, Kulacoglu IH, Oruc MT, Duzgun AP, Moran M, Ozmen MM, Coskun F (2001) Presentation and outcome of incarcerated external hernias in adults. Am J Surg 181:101–104

    Article  CAS  PubMed  Google Scholar 

  10. Brasso K, Nielsen KL, Christiansen J (1989) Long-term results of surgery for incarcerated groin hernias. Acta Chir Scand 155:583–585

    CAS  PubMed  Google Scholar 

  11. Glassow F (1985) Femoral hernia: Review of 2,105 repairs in a 17-year period. Am J Surg 150:353–356

    CAS  PubMed  Google Scholar 

  12. Heydorn WH, Velanovich V (1990) A five-year U.S. Army experience with 36,250 abdominal hernia repairs. Am Surg 56:596–600

    CAS  PubMed  Google Scholar 

  13. Sandblom G, Haapaniemi S, Nilsson E (1999) Femoral hernias: a register analysis of 588 repairs. Hernia 3:131–134

    Google Scholar 

  14. Wysocki A, Pozniczek M, Krzywon J, Strzalka M (2002) Lichtenstein repair for incarcerated groin hernias. Eur J Surg 168:452–454

    Article  CAS  PubMed  Google Scholar 

  15. The EU Hernia Trialists Collaboration (2002) Repair of groin hernia with synthetic mesh. Ann Surg 235:322–332

    Article  PubMed  Google Scholar 

  16. Hernández-Granados P, Ontañón M, Lasala M, García C, Arguello M, Medina I (2000) Tension-free hernioplasty in primary inguinal hernia. A series of 2 054 cases. Hernia 4:141–143

    Google Scholar 

  17. Oskvig RM (1999) Special problems in the elderly. Chest 115 (suppl):158–164

    Article  PubMed  Google Scholar 

  18. Rai S, Chandra SS, Smile SR (1998) A study of the risk of strangulation and obstruction in groin hernias. Aust N Z J Surg 68:650–654

    CAS  PubMed  Google Scholar 

  19. Kulacoglu H, Kulah B, Hatipoglu S, Coskun F (2000) Incarcerated direct inguinal hernias: a three-year series at a large volume teaching hospital. Hernia 4:145–147

    Google Scholar 

  20. Chamary VL (1993) Femoral hernias: intestinal obstruction is an unrecognized source of morbidity and mortality. Br J Surg 80:230–232

    CAS  PubMed  Google Scholar 

  21. Brittenden J, Heys SD, Eremin O (1991) Femoral hernia: mortality and morbidity following elective and emergency surgery. J R Coll Surg Edinb 36:86–88

    CAS  PubMed  Google Scholar 

  22. McEntee G, Pender D, Mulvin D, McCullough M, Naeeder S, Farah S, Badurdeen MS, Ferraro V, Cham C, Gillham N, Matthews P (1987) Current spectrum of intestinal obstruction. Br J Surg 74:976–980

    CAS  PubMed  Google Scholar 

  23. Askew G, Williams GT, Brown SC (1992) Delay in presentation and misdiagnosis of strangulated hernia: prospective study. J R Coll Surg Edinb 37:37–38

    CAS  PubMed  Google Scholar 

  24. Nesterenko IVA, Shovskii OL (1993) Outcome of treatment of incarcerated hernia. Khirurgiia (Mosk) 9:26–30

    Google Scholar 

  25. Nicholson S, Keane TE, Devlin HB (1999) Femoral hernia: an avoidable source of surgical mortality. Br J Surg 77:307–308

    Google Scholar 

  26. Golub R, Cantu R (1998) Incarcerated anterior abdominal wall hernias in a community hospital. Hernia 2:157–161

    Google Scholar 

  27. Kulah B, Duzgun AP, Moran M, Kulacoglu IH, Ozmen MM, Coskun F (2001) Emergency hernia repairs in elderly patients. Am J Surg 182:455–459

    Article  CAS  PubMed  Google Scholar 

  28. Young DV (1987) Comparison of local, spinal, and general anesthesia for inguinal herniorrhaphy. Am J Surg 153:560–563

    CAS  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank Ms. María José Martínez Samalea for her support in the translation of this report.

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  1. J. A. Álvarez

    Present address: , Avenida de Galicia 46–3º A, 33005, Oviedo, Spain

Authors and Affiliations

  1. Service of General Surgery, Hospital San Agustín, Avilés, Spain

    J. A. Álvarez, R. F. Baldonedo, I. G. Bear, J. A. S. Solís, P. Álvarez & J. I. Jorge

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  1. J. A. Álvarez
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  2. R. F. Baldonedo
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  3. I. G. Bear
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  4. J. A. S. Solís
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  5. P. Álvarez
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  6. J. I. Jorge
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Correspondence to J. A. Álvarez.

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Álvarez, J.A., Baldonedo, R.F., Bear, I.G. et al. Incarcerated groin hernias in adults: Presentation and outcome. Hernia 8, 121–126 (2004). https://doi.org/10.1007/s10029-003-0186-1

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  • DOI: https://doi.org/10.1007/s10029-003-0186-1

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