Description
The commonest types of external hernias are inguinal 63.4%, umbilical 19%, epigastric
5% and femoral hernia 0.7%.
An average 31 patients per year were admitted with incarcerated/strangulated external
hernias (incidence).
Incarceration/strangulation of external hernias predominantly occurs in males
(male:female ratio of 12:1) and mostly occur on the right side (in this study right 68.7%
vs left 24.6%).
Some external hernia incarcerate/strangulate more easily than others. In this study,
hernias with the highest incarceration rate include femoral 33.3%, inguinal 13.33%,
umbilical 7.06% and epigatric 4.26%.
The mean age of patients in this study was 26.1 years and the commonest age group was
21-50 years (48.4%). The commonest presenting features were local hernial site pain
(98.9%) and local hernial swelling (97.9%).
Age (the very young and very old) and co-morbid condition increased morbidity and
mortality. In this study, 3 of the 4 patients who died were aged 10 weeks and had gastroenteritis.
Duration of hernia for less than a year increased the risk or chances of
incarceration/strangulation. In this study, 76% of the patients had hernia for less than one
year.
The commonest complication in this study included testicular edema/hematoma (3.7%)
and wound sepsis (2.1%).
The most prevalent associated factors include: chronic cough 12.2%, straining at
micturation 4.8% and straining at defaecation 3.72%.
Of 188 patients admitted, 159 (84.6%) patients had emergency surgery and 29 (15%)
conservative management. In the latter group, in 8 patients their hernia reduced
spontaneous and in 21 patients, the hernia was reduced under sedation (pethidine/valium)
especially in children.
Thus it is recommended that early repair of hernia is performed in all hernias and
especially in the very young, very elderly, patients with short history of hernia and certain
types of hernia (inguinal hernia in children and femoral hernias in adults).