부산대학교 도서관

INRODUCTION Although majority of the abdominal wall hernias (AWHs) are asymptomatic, they can cause serious problems if they are complicated or left untreated. An incarcerated hernia may not require immediate [...]
BACKGROUND/AIMS The goal of the present study was to determine the factors affecting strangulation and necrosis in incarcerated abdominal wall hernias (AWHs). MATERIAL and METHODS This was a retrospective study conducted by reviewing the medical records of 44 patients who underwent surgery for incarcerated abdominal wall hernia at a university hospital between April 2009 and January 2018. RESULTS Of the 44 study patients, 28 were men and 16 were women of mean age 68.95 years. Of all, 30 patients (68.2%) had groin hernias (femoral: 7, inguinal: 23) and 14 (31.8%) had ventral hernias (incisional: 8, umbilical: 5, epigastric: 1). The intraoperative findings were strangulation in 24 (54.5%) and necrosis in 20 (45.5%) cases. Accordingly, omental resection was performed in 4, small bowel resection in 14, and large bowel resection in two patients. The hernia was repaired using a polypropylene mesh in 33 patients (of them 20 were Lichtenstein, 8 were on-lay, and 5 were plug-mesh) and without using a mesh in ten patients. The hernia was not repaired in one patient. The mean duration of hospitalization was 7.43 (range: 1-5) days. The mortality rate was 13.6%. In univariate analysis, the mortality was positively related to necrosis (p=0.045). The duration of these symptoms was the only factor that affected strangulation and necrosis. CONCLUSION The mortality rate was high in incarcerated abdominal wall hernias, while necrosis was the most significant variable associated with mortality. The duration of the symptoms was the most significant factor that affected necrosis; therefore, it is essential to perform surgical intervention within the first 24 h of admission. Keywords: Abdominal wall hernia, incarcerated hernia, irreducible hernia, necrosis, obstruction, strangulated hernia