Muhammad Anwer Memon, Mohammad Rafique Pathan, Karim Bux.
Giant inguinal hernia; complications and their management in patients.
Professional Med J Jan ;23(12):1495-8.

Objectives: To determine the complications and their management in patients with giant inguinal hernia. Place and Duration of Study: This study was carried out in in Surgical Unit-IV, Liaquat University Hospital Jamshoro, from October 2013 to December 2015. Methodology: This study consisted of 30 patients of giant inguinoscrotal hernias. Detailed History was taken from all the patients with special regard to the inguinoscrotal swelling. Detailed Clinical examination of the patient was done .Site of swelling was especially examined for assessment of three grades. Grade–I means hernia reaching upto middle of thigh, Grade-II means inguinoscrotal contents reaching upto knee joint and Grade-III means contents going below knee level. All data was entered in a specified proforma designed for this purpose. Inclusion criteria were all diagnosed patients of giant inguinoscrotal hernia on the basis of history, clinical examination were included in this study. Exclusion criteria included patients unfit for surgery, patients below age of 12 years, patients with severe co-morbidity and morbid obese patients. Results: 30 patients included in this study. There was wide variation of age ranging from a minimum of 30 years to 70 years , mean age was 46.28+7.20 years. The patients presented with more common in right side 21(70%) cases and left side 9(30%) cases. Patients presented with grade-I 11(36.66%) cases, grade-II 9(30%) cases, grade-III 7(23.33%) cases and grade IV 3(10%) cases. Giant inguinal hernia were operated Orchidectomy and hernioplasty 12(40%) cases, followed by Debulkation of contents and hernioplasty 9(30%) cases and Gradual Pneumoperitoneum and hernioplasty 4(13.33%) cases. Complications seen in this study was Respiratory in 3(10%) patients, Abdominal compartmental syndrome in 1(3.33%) patients, Paralytic Ileus in 2(6.66%) patients and Wound Infections in 4(13.33%). Conclusion: In conclusion our study revealed it is commonly to live in our population due to ignorance of hernia poverty in remote areas and lack of knowledge of disease complications.

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