Abstract

Fente BG and Ukoima HS

The aim of this study is to document our first experiences in the surgical management and outcome of incarcerated external anterior wall hernias (EAAWH) in our local environment, outlining the clinical profile, treatment outcome and identify predictors of outcome among these patients. The study design used was a retrospective analysis of data. The study was conducted at the Department of Surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria from January 2008 to December 2012. Records of 29 patients who underwent emergency surgery for incarcerated external anterior abdominal wall hernia in a teaching hospital were analyzed for age, sex, type of hernia, characteristics of clinical presentation, duration of symptoms, past medical history, and significant concomitant diseases, ASA class, type of anesthesia, contents of the hernia sac, surgical procedures, complications, duration of hospital stay and mortality. Twenty-four (82.76%) patients were males and 5 (17.24%) were females. The age of patients ranged from 1 month to 75 years. There were 28 (96.5%) Inguinal hernias, 1 (3.5%) Para-umbilical hernias and none of Incisional and femoral hernias. Gut resection was done in 4 (13.8%) patients. The mortality rate was 3.5%. The mortality was related to septicemia from gangrenous bowel in a one month old child and late presentation. Mortality associated with emergency surgery of incarcerated external anterior abdominal hernias is related to late presentation with subsequent bowel gangrene, very young age, and associated medical illnesses.