Skip to main content
SpringerLink
Log in

Predictive factors of bowel necrosis in patients with incarcerated femoral hernia

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Purpose

Intestinal necrosis is a frequent complication in patients with incarcerated femoral hernias (IFH). Knowing the low incidence of IFH, few series with large samples studied predictive factors of intestinal necrosis.

The main objectives of our study were to determine the predictive preoperative factors of intestinal necrosis in patients with IFH and to compare its morbidity with that related to incarcerate inguinal hernias (IIH).

Methods

We conducted a retrospective observational cohort study in which we included patients with incarcerated groin hernias (IGH).

This is a single-center study between January 2004 and December 2021. Patients were divided into two groups: group A (admitted for IFH) and group B (admitted for IIH). Intestinal necrosis was confirmed intraoperatively.

Results

383 patients with IGH were included in the study: 91 patients had IFH (23.76%) and 282 patients had IIH (76.24%). In patients with IFH, the median age was 67 years. We had 60 females (66%) and 31 males (34%). Bowel ischemia was present in 29 patients (32%). Bowel necrosis was present in 14 patients (16%). We identified three independent variables predicting bowel necrosis in patients with IFH: Duration from symptoms to surgery, NLR (Neutrophil to Lymphocyte ratio), and urea.

Bowel ischemia and bowel necrosis were significantly higher in patients with IFH compared to those with IIH.

Conclusions

In summary, we found that duration from symptoms to surgery, NLR, and urea were significantly predictive of intestinal necrosis in patients with IFH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Alimoglu O, Kaya B, Okan I, Dasiran F, Guzey D, Bas G, Sahin M (2006) Femoral hernia: a review of 83 cases. Hernia J Hern Abdom Wall Surg 10(1):70–73. https://doi.org/10.1007/s10029-005-0045-3

    Article  CAS  Google Scholar 

  2. Hachisuka T (2003) Femoral hernia repair. Surg Clin North Am 83(5):1189–1205. https://doi.org/10.1016/S0039-6109(03)00120-8

    Article  PubMed  Google Scholar 

  3. Alvarez JA, Baldonedo RF, Bear IG, Solís JA, Alvarez P, Jorge JI (2004) Incarcerated groin hernias in adults: presentation and outcome. Hernia J Hernias Abdomin Wall Surg 8(2):121–126. https://doi.org/10.1007/s10029-003-0186-1

    Article  CAS  Google Scholar 

  4. Jiang XM, Sun RX, Huang WH, Yu JP (2019) Midline preperitoneal repair for incarcerated and strangulated femoral hernia. Hernia J Hernias Abdomin Wall Surg 23(2):323–328. https://doi.org/10.1007/s10029-018-1848-3

    Article  Google Scholar 

  5. Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U (2009) Emergency femoral hernia repair: a study based on a national register. Ann Surg 249(4):672–676. https://doi.org/10.1097/SLA.0b013e31819ed943

    Article  PubMed  Google Scholar 

  6. Derici H, Unalp HR, Bozdag AD, Nazli O, Tansug T, Kamer E (2007) Factors affecting morbidity and mortality in incarcerated abdominal wall hernias. Hernia J Hernias Abdomin Wall Surg 11(4):341–346. https://doi.org/10.1007/s10029-007-0226-3

    Article  CAS  Google Scholar 

  7. Humes DJ, Radcliffe RS, Camm C, West J (2013) Population-based study of presentation and adverse outcomes after femoral hernia surgery. Br J Surg 100(13):1827–1832. https://doi.org/10.1002/bjs.9336

    Article  CAS  PubMed  Google Scholar 

  8. Liu X, Zheng G, Ye B, Chen W, Xie H, Zhang T (2018) Risk factors for surgical opportunity in patients with femoral hernia: a retrospective cohort study. Medicine 97(34):e11826. https://doi.org/10.1097/MD.0000000000011826

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kurt N, Oncel M, Ozkan Z, Bingul S (2003) Risk and outcome of bowel resection in patients with incarcerated groin hernias: retrospective study. World J Surg 27(6):741–743. https://doi.org/10.1007/s00268-003-6826-x

    Article  PubMed  Google Scholar 

  10. Chen P, Huang L, Yang W, He D, Liu X, Wang Y, Yu Y, Yang L, Zhou Z (2020) Risk factors for bowel resection among patients with incarcerated groin hernias: a meta-analysis. Am J Emerg Med 38(2):376–383. https://doi.org/10.1016/j.ajem.2019.09.023

    Article  PubMed  Google Scholar 

  11. Tanaka N, Uchida N, Ogihara H, Sasamoto H, Kato H, Kuwano H (2010) Clinical study of inguinal and femoral incarcerated hernias. Surg Today 40(12):1144–1147. https://doi.org/10.1007/s00595-009-4193-4

    Article  PubMed  Google Scholar 

  12. Alhambra-Rodriguez de Guzmán C, Picazo-Yeste J, Tenías-Burillo JM, Moreno-Sanz C (2013) Improved outcomes of incarcerated femoral hernia: a multivariate analysis of predictive factors of bowel ischemia and potential impact on postoperative complications. Am J Surg 205(2):188–193. https://doi.org/10.1016/j.amjsurg.2012.03.011

    Article  PubMed  Google Scholar 

  13. Suppiah A, Gatt M, Barandiaran J, Heng MS, Perry EP (2007) Outcomes of emergency and elective femoral hernia surgery in four district general hospitals: a 4 year study. Hernia J Hernias Abdomin Wall Surg 11(6):509–512. https://doi.org/10.1007/s10029-007-0262-z

    Article  CAS  Google Scholar 

  14. Ge BJ, Huang Q, Liu LM, Bian HP, Fan YZ (2010) Risk factors for bowel resection and outcome in patients with incarcerated groin hernias. Hernia J Hernias Abdomin Wall Surg 14(3):259–264. https://doi.org/10.1007/s10029-009-0602-2

    Article  Google Scholar 

  15. Xie X, Feng S, Tang Z, Chen L, Huang Y, Yang X (2017) Neutrophil-to-Lymphocyte ratio predicts the severity of incarcerated groin Hernia. Med Sci Monit Intern Med J Exper Clin Res. 23:5558–5563

    Google Scholar 

  16. Bouassida M, Dougaz MW, Beji H, Guermazi H, Zribi S, Kammoun N, Bouasker I, Mongi Mighri M, Nouira R, Touinsi H (2022) Intestinal ischemia in patients with incarcerated groin hernia: proposal and validation of a score. Langenbecks Arch Surg 407(6):2547–2554. https://doi.org/10.1007/s00423-022-02521-9

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bouassida M, Laamiri G, Zribi S, Slama H, Mroua B, Sassi S, Aboudi R, Mighri MM, Bouzeidi K, Touinsi H (2020) Predicting intestinal ischaemia in patients with adhesive small bowel obstruction: a simple score. World J Surg 44(5):1444–1449. https://doi.org/10.1007/s00268-020-05377-6

    Article  PubMed  Google Scholar 

  18. HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia J Hernias Abdomin Wall Surg 22(1):1–165. https://doi.org/10.1007/s10029-017-1668-x

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia

    H. Beji, M. Bouassida, M. F. Chtourou, S. Zribi, G. Laamiri, Y. Kallel, B. Mroua, M. M. Mighri & H. Touinsi

  2. Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia

    H. Beji, M. Bouassida, M. F. Chtourou, S. Zribi, G. Laamiri, Y. Kallel, B. Mroua, M. M. Mighri & H. Touinsi

Authors
  1. H. Beji
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Bouassida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. F. Chtourou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Zribi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Laamiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Y. Kallel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B. Mroua
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. M. Mighri
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. H. Touinsi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. Beji.

Ethics declarations

Conflict of interest

We declare no competing interests.

Ethical approval

Ethical approval was waived by the Ethics Committee of the Hospital Mohamed Taher Maamouri in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Human and animal rights

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Beji, H., Bouassida, M., Chtourou, M.F. et al. Predictive factors of bowel necrosis in patients with incarcerated femoral hernia. Hernia 27, 1491–1496 (2023). https://doi.org/10.1007/s10029-023-02776-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-023-02776-1

Keywords

Search

Navigation