A study on groin hernias presenting as acute surgical emergencies in adults

Abstract

Background: Inguinal hernias form the commonest subgroup of various hernias; such common condition causes the problem of various complications. A minority of patients with a groin hernia present as an emergency, with a painful and irreducible mass or with intestinal obstruction and delay in presentation is known to result in high morbidity and mortality. Aim was to study about the various acute surgical emergencies in groin hernia with its complications and surgical treatments.Methods: This study was a prospective observational study, conducted in the Department of General Surgery, Saveetha Medical College and Hospital, during March 2015 to February 2017. Thirty-five patients were included in the study. Ethical committee clearance was obtained prior to the commencement of study. All patients were studied from time of admission till discharge and followed up in out-patient department. A detailed history was elicited, and clinical examination was performed, and data recorded. All patients were given pre-and post-operative care.Results: The incidence of hernia was 37.1% for age group of 60 to 69 years whereas it was 28.6% for age group of 50 to 59 years and incidence decreases there by as age decreases. The frequency of hernia in male (94.3%) was more when compared to female (5.7%). The duration of hernia frequency before acute episode was more in first year (54.3%). The right sided hernia was most complicated than left. The common site of constriction was deep inguinal ring than the superficial inguinal ring and femoral ring.Conclusions: Majority of the patients underwent herniorraphy (82.8%). Most common site of constriction was observed to be at the deep ring (71.4%). The most common content was small bowel followed by omentum (74.3% and 25.7% respectively). Most of the patients did not have any post-operative complications (80%). Wound infection was the most common complication (11.5%) and mortality was observed in two patients (5.7%) and the causes of death were sepsis and acute respiratory distress syndrome.