Presentation and outcome of strangulated external abdominal hernias

Objective: to study the presentation,morbidity and mortality associated with strangulated external abdominal hernias. study design: a retrospective analysis of data. place and duration: surgical unit-1 ghulam mohammad maher medical college hospital sukkur. january 2007 to december 2008. methods: records of 85 patients who underwent emergency surgery for strangulated external abdominal hernia in a teaching hospital were analyzed for age,sex,type of hernia (inguinal,femoral,umbilical,incisional),duration of symptoms,past history,medical and surgical history,investigations,contents of hernial sac,surgical procedure,length of hospital stay,complications and mortality. results: sixty-one (71.8%) patients were males and 24 (28.2%) were females. age of patients ranged from 16 to 90 years and mean age was 52 years. there were 50 (58.9%) inguinal hernias,22 (25.9%) para-umbilical hernias,9 (10.5%) incisional hernias,and 4 (4.7%) femoral hernias. twenty-three percent of patients presented after 48 hours of onset of symptoms. coexisting diseases were present in 24.4% patients. gut resection was done in 15 (17.6%) patients and stoma formation required in 9 (10.6%) patients. the morbidity and mortality rates were 29.1% and 8.3% respectively. the mortality was related to old age with coexisting medical illnesses and late hospitalization. conclusion: there is high morbidity and mortality associated with emergency surgery of strangulated external abdominal hernias,which was related to late presentation leading to subsequent bowel gangrene,misdiagnosis,old age,and associated medical illnesses.