Management of strangulated inguinal hernias in a district hospital: About 73 cases

Abstract

Abstract BACKGROUND: Hernial strangulation is a surgical emergency characterized by tight, permanent constriction of the contents of the hernial sac. It is also called an irresistible hernia with impairment of perfusion. This work aims to evaluate the results of the management of strangulated hernias in a district hospital. METHOD: This was a cross-sectional study with prospective descriptive and analytical collection carried out in the General Surgery Department of Tessaoua District Hospital (Maradi, Niger), covering patients operated on for strangulated inguinal hernias managed from January 2020 to February 2022. RESULTS: We collected 73 cases of strangulated hernias representing 2.76% of admitted surgical emergencies and 1.92% of surgical procedures. The mean age was 49.30 years with extremes ranging from 20 to 80 years and a standard deviation of ±17.21. The sex ratio was 8.13. The admission time was less than 6 h in 45.21% of cases, between 6 and 9 h in 38.36% and more than 9 h in 15.07%. On exploration, the contents were of normal appearance in 61.64%; 17 cases whose contents were already necrotic, that is 23.29%, and 11 cases of sphacelic appearance, that is 15.07%. Anastomotic resection was performed in 21.92% of cases, followed by Desarda in 26.03% and Mac Vay in 12.33%. The average hospital stay was 7 days. CONCLUSION: Strangulated hernia is a frequent pathology in developing countries. Patients with a simple hernia must go for consultation, hence the importance of raising awareness for early management.