Abdominal wall hernias in patients with abdominal aortic aneurysmal versus aortoiliac occlusive disease

Increased prevalence of abdominal aortic aneurysm in patients undergoing inguinal hernia repair compared with patients without hernia receiving aneurysm screening

“…12,14 Furthermore, an elevated prevalence of inguinal hernias among patients with aortic aneurysm compared with patients treated for aortoiliac occlusive and coronary artery disease has been described. 15,18,19 However, there are limited data regarding the reverse association of these conditions, and the identification of patients with inguinal hernia as a high-risk group for AAA has not been adequately investigated.…”

Abdominal aortic aneurysm and abdominal wall hernia as manifestations of a connective tissue disorder

“…The initial presumption that an independent relationship exists between AAAs and incisional hernias formation has been documented by several reports. [9][10][11][12][13][14][15][16][17][18] Comparative studies evaluating the incidence of postoperative incisional hernias report values ranging between 10% and 37% for patients treated for AAAs, and 3% and 19% for those having aortoiliac reconstruction for occlusive disease. An updated meta-analysis of published reports found that patients who had a midline laparotomy for AAA repair had a 2.9-fold increased risk of developing postoperative incisional hernia compared with those with aortoiliac occlusive disease (odds ratio [OR], 2.86; 95% confidence interval [CI], 1.97-4.16; P Ͻ .00001; Fig 1).…”

The Biology of Hernia Formation

“…15 A genetic predisposition to the formation of abdominal wall hernias was also suggested in large, controlled series of abdominal aortic aneurysm patients supporting the long held impression of a common extra-cellular matrix defect in both vascular wall and abdominal wall collagen metabolism. [32][33][34][35] The mechanism by which the collagen-rich early laparotomy wound matrix attaches to uninjured tissue at the wound border is also poorly understood. This mechanism is important since acute laparotomy wounds most often fail at the scar to normal tissue interface.…”