Ghulam Hyder Rind, Atta Hussain Soomro, Muhammad Ayoob, Zulfiqar Ali Bhatti, Khush Muhammad Sohu.
Presentation and outcome of strangulated external abdominal hernias.
J Liaquat Uni Med Health Sci Jan ;9(1):04-8.

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.

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