Changing pattern of adult external abdominal hernias in Zaria

Abstract

Background: External abdominal hernias are very common diseases encountered in surgical practice. A previous report from this centre 21 years ago documented the pattern of adult external abdominal hernias. However, there is an observed changing pattern. The aim of the study was to document the changing pattern, mode of presentation, treatment and outcome. Methods: It was a 5-year prospective study from January 2011 to December 2015. Adult patients with external abdominal hernia at our institution were studied. Information documented included patients' sociodemographic information, type of hernia, mode of presentation, treatment and outcome. Results: Six hundred and thirty-seven out of 4,083 patients with general surgical cases had external abdominal hernias (15.6%), with a male:female ratio of 3.1:1. The types of hernia were inguinal (451 [70.8%]), umbilical (83 [13.0%]), incisional (54 [8.5%]), epigastric (31 [4.9%]), femoral (14 [2.2%]) and others (4 [0.6%]). The common modes of presentation for inguinal hernias were simple (364 [80.7%]) and strangulated (42 [9.3%]). The most common mode of treatment for inguinal hernias was modified Bassini (265 [58.8%]). The common post-operative morbidities for groin hernias were wound infection (18 [3.9%]) and acute urinary retention (10 [2.2%]). The 3-year recurrence rate for groin hernias was 14 (3.0%). Mortality was three (0.5%) patients. Conclusion: The pattern of external abdominal hernias in our institution has changed with the descending order of occurrence as follows: inguinal, umbilical, incisional, epigastric and femoral. This is in contrast to previous reports where femoral was the second most common. Modified Bassini was the preferred method of repair of inguinal hernia due to its simplicity.