Obesity Increases the Odds of Acquiring and Incarcerating Noninguinal Abdominal Wall Hernias

Abstract

The current data available describing the relationship of obesity and abdominal wall hernias is sparse. The objective of this study was to investigate the current prevalence of noninguinal abdominal wall hernias and their correlation with body mass index (BMI) and other demographic risk factors. Patients with umbilical, incisional, ventral, epigastric, or Spigelian hernias with or without incarceration were identified using the regional database for 14 hospitals over a 3-year period. Patients were stratified based on their BMI. Univariate and multivariate analyses were performed to distinguish other significant risk factors associated with the hernias. Of 2,807,414 patients, 26,268 (0.9%) had one of the specified diagnoses. Average age of the patients was 52 years and 61 per cent were male. The majority of patients had nonincarcerated umbilical hernias (74%). Average BMI was 32 kg/m2. Compared with patients with a normal BMI, the odds of having a hernia increased with BMI: BMI of 25 to 29.9 kg/m2 odds ratio (OR) 1.63, BMI of 30 to 39.9 kg/m2 OR 2.62, BMI 40 to 49.9 kg/m2 OR 3.91, BMI 50 to 59.9 kg/m2 OR 4.85, and BMI greater than 60 kg/m2 OR 5.17 ( P < 0.0001). Age older than 50 years was associated with a higher risk for having a hernia (OR, 2.12; 95% [CI], 2.07 to 2.17), whereas female gender was associated with a lower risk (OR, 0.53; 95% CI, 0.52 to 0.55). Those with incarcerated hernias had a higher average BMI (32 kg/m2 vs 35 kg/m2; P < 0.0001). Overall, BMI greater than 40 kg/m2 showed an increased chance of incarceration, and a BMI greater than 60 kg/m2 had the highest chance of incarceration, OR 12.7 ( P < 0.0001). Age older than 50 years and female gender were also associated with a higher risk of incarceration (OR, 1.28; 95% CI, 1.02 to 1.59 and OR, 1.80; CI, 1.45 to 2.24). Increasing BMI and increasing age are associated with a higher prevalence and an increased risk of incarceration of noninguinal abdominal wall hernias.

Prevalence, risk factors and character of abdominal hernia in Arar City, Northern Saudi Arabia in 2017

“…These findings were supported by Russell in 2000, who stated that obesity plays an important role as a risk factor for hernias. Increasing BMI and increasing age are associated with a higher prevalence and an increased risk of incarceration of non-inguinal abdominal wall hernias ( 13 ). Another factor is that the musculature can be overburdened through increased food intake, as in cases of obesity.…”

Umbilical hernia with cholelithiasis and hiatal hernia: a clinical entity similar to Saint’s triad

“…The risk factors for hiatal hernia, however, are speculative; a few reports have identified obesity [ 22 ] and pregnancy [ 23 ] as risk factors. The risk factors for umbilical hernia in adults are age [ 24 ], female sex [ 25 ], obesity [ 26 ], abdominal distension, ascites, and pregnancy [ 25 ]. To the best of our knowledge, there are no reports on the coexistence of umbilical hernia and any of these three diseases.…”

Strangulated epigastric hernia in a 90-year-old man: Point-of-Care Ultrasound (POCUS) as a saving kit: Case report

“…More than one-fifth of the world’s population is anticipated to be older than 60 years by 2050 [8] . Age older than 50 years increases the risk of incarceration of non inguinal abdominal wall hernias [9] . The incarcerated epigastric hernia which is located in the upper abdomen may contain an ischaemic bowel as occurred in our patient.…”