Abstract
Aim: To evaluate the predictive or diagnostic value of inflammatory markers in the presence of bowel necrosis in patients with an incarcerated inguinal hernia.
 Material and Methods: The sample consisted of 246 patients that were admitted to the Emergency Service of Ankara Numune Training and Research Hospital and were operated on between January 2013 and January 2018 with a diagnosis of incarcerated inguinal hernia (IIH). The electronic patient records were screened to obtain the blood test results pertaining to lymphocyte count, neutrophil count, neutrophil/lymphocyte ratio (NLR), red cell distribution width (RDW), platelet count, and RDW/platelet ratio; surgical notes concerning resection status and inguinal hernia type; and demographic data. The patients included in the study were divided into two groups as those that had received a bowel resection and those that had not undergone this procedure.
 Results: Of the 246 patients, 159 (65%) were male and 87 (35%) were female. The median age (interquartile range) was 71 (66-78) years and 62 (50-74) years in the resection (n= 23) and non-resection (n= 223) groups, respectively. There was a statistically significant difference between the two groups in terms of age (p= 0.004), neutrophil count (0.001), NLR (p= 0.000), and lymphocyte count (0.000). The multivariate analysis revealed that NLR (odds ratio= 1.113, 95% confidence interval value: 1.055-1.175, and p= 0.000) was individually, independently and significantly associated with bowel resection. 
 Conclusion: Considering that it is possible to prevent the strangulation of a hernia in patients with IIH, urgent surgery is recommended for patients with an NLR of > 6.5.
Highlights
Inguinal hernias are frequently encountered in current surgical practice
Bowel resection is more common in femoral hernias than in other types of hernia, this procedure is undertaken in a considerable percentage (15%) of all cases of incarcerated inguinal hernia (IIH) [1]
The sample consisted of 246 patients diagnosed with IIH, of whom 159 (65%) were male and 87 (35%) were female
Summary
Inguinal hernias are frequently encountered in current surgical practice. Levels of morbidity and mortality vary according to the resection status in emergency surgery. Bowel resection is more common in femoral hernias than in other types of hernia, this procedure is undertaken in a considerable percentage (15%) of all cases of incarcerated inguinal hernia (IIH) [1]. Studies have reported that bowel strangulation occurs in 57% of femoral hernias, with the morbidity and mortality being 33% and 7%, respectively for patients that require resection due to this condition [2]. There are very few studies in the literature related to inflammatory markers that predict early strangulation in emergency inguinal hernias [4].
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