Hernia In South Southern Nigeria: Five Year Retrospective Study.

Abstract

years 49 (12.7%), 60-69 years 36 (9.3%), 70-79 years 20 (5.2%), 10-19 years 16 (4.1%), 80-89 years and less than 10 years with 4 (1.0%) each respectively. Most of the cases were done by Senior Registrars 221 (57.3%) then Consultants 105 (27.2%), while Registrars did 60 (15.5%). The hernias were mostly inguinal with reducible right inguinal hernia constituting the highest 121(31.1%), Reducible left inguinal hernias 81 (21.0%), Obstructed right inguinal hernias were 44 (11.4%), incisional hernia were 38 (9.8%), umbilical hernia 27 (7.0%), Bilateral inguinal hernias were 26 (6.7%), epigastric hernias were 25 (6.5%), obstructed supraumbilical hernias were 9 (2.3%), left femoral hernias were 5 (1.3%), obstructed left femoral and obstructed epigastric were both 4 (1.0%) each and right femoral and bilateral femoral hernias were 1 (0.3%) each respectively. The type of hernia repair done was nylon darn in 313 (81.1%), those requiring both exploratory laparotomy and herniorrhaphy were 36 (9.3%), bilateral herniorrhaphy was done in 15 (3.9%). Mayo’s type of repair was done in 9 (2.3%) and repair with mesh was done in 4 (1.0%) as well as in herniotomy. Primary repair in layers was in 3 (0.8%). Herniorrhaphy with orchidectomy was 2 (0.5%). The anaestheia done was mostly sub arachnoid block 297 (76.9%), general anaesthesia was done in 69 (17.9%), local infilteration was 18 (4.7%), total intravenous anaesthesia (TIVA) and field block 1 (0.3%) each. Most of the surgery lasted between 50-99 minutes 214 (55.4%), then followed by less than 50 minutes 78 (20.2%), 100-149 minutes 66 (17.1%), 150-199 minutes 19 (4.9%), 200-249 minutes 4 (1.0%), 250-299 minutes 2 (0.5%), 300-349, 350-399 and greater than 400 minutes with 1 (0.3%) respectively. Conclusion: Hernia in South Southern Nigeria has quite a large magnitude of clinical impact in our environment. The indirect inguinal hernia being the most common with male sex preponderace. Sub-aracnoid block is the most common form of anaesthesia utilized with most herniorrhaphies done by the senior registrars.