The role of umbilical hernia sac neck ratio in predicting the development of symptoms and complications

Abstract

Background: The morphology of an umbilical hernia is important in deciding the course of symptoms and complications as a hernia with a narrow neck and a large sac is more prone to complications. At present there are no fixed guidelines on when to operate on an umbilical hernia. This study considers the morphological characteristics of the hernia using the hernia sac-neck ratio and an ultrasound as a non invasive tool in predicting the development of symptoms and complications. Methods: This study is a DESCREPTIVE/OBSERVATIONAL study conducted at JSS HOSPITAL MYSORE from November 2017 to December 2019. For All cases presenting to JSS hospital with an umbilical hernia an ultrasound abdomen was performed to note the size of the neck of the hernia. The diameter of the hernia was measured clinically and the required ratio calculated.Results: Out of the 50 patients in the study 40 were complicated and 10 uncomplicated. the mean hernia neck size in the complicated group was 2.02 cm with a P value of 0.091 un complicated group which is 2.95 cm. The mean hernia sac neck ratio which is the area of interest in this study was more in the complicated group at 2.97 and much lesser in the uncomplicated group at 2.02 and based on the ROC curve analysis at cut off ratio of 2.2 was associated with a 90% sensitivity and a 70% specificity.Conclusion: This study concludes that patients with a smaller neck and a larger sac are more prone to develop complications and the Hernia sac neck ratio can be used as a sensitive tool in predicting the same.