Emergency Presentation of Abdominal Hernias: Outcome and Reasons for Delay in Treatment – A Prospective Study
- 1 January 2007
- journal article
- Published by Royal College of Surgeons of England in The Annals of The Royal College of Surgeons of England
- Vol. 89 (1), 47-50
- https://doi.org/10.1308/003588407x160855
Abstract
INTRODUCTION: Emergency hernia surgery is associated with a higher postoperative complication and a less favourable outcome. The aim of this study was to audit emergency presentations of abdominal hernias prospectively in order to identify delays in patient treatment. PATIENTS AND METHODS: Prospective audit was carried out between January and September 2003 of all patients presenting acutely with symptomatic hernias. In total, 55 patients presented, 39 of whom needed surgical intervention. The emergency repairs were compared with a cohort of elective repairs performed in the trust at the same time. RESULTS: The median age was 77 years (range, 5–92 years; 35 male, 20 female). The distribution of the hernias, requiring surgery, was inguinal (19), para-umbilical (10), incisional (5) and femoral (5). The overall complication rate was 46.2% and the in-patient stay was 4 days (range, 1–49 days). Six patients required small bowel resection. Conservative management was identified as a key contributing factor in the delay of treatment. There was a significant increase in the in-patient stay, the early complication rate and the small bowel resection rate in the emergency repairs. DISCUSSION: Patients with a symptomatic hernia should be offered elective, surgical repair. Non-operative management is inappropriate for the vast majority of cases, especially when many repairs may be performed with local anaesthetic infiltration. Clinicians should be aware of the high morbidity associated with the emergency repair of abdominal hernias in the elderly.Keywords
This publication has 19 references indexed in Scilit:
- Incarcerated groin hernias in adults: Presentation and outcomeHernia, 2004
- Inguinal hernia: Challenging the traditional indication for surgery in asymptomatic patientsHernia, 2004
- Hernias of the Abdominal Wall in Patients Over the Age of 70 YearsBritish Journal of Surgery, 2002
- ABDOMINAL WALL HERNIASEmergency Medicine Clinics of North America, 1996
- Contributions of the Surgical Sciences to a Reduction of the Mortality Rate in the United States for the Period 1968 to 1988Annals of Surgery, 1994
- Femoral hernia: An avoidable source of surgical mortalityBritish Journal of Surgery, 1990
- Timing of strangulation in adult herniasBritish Journal of Surgery, 1989
- Presentation and outcome of strangulated external hernia in a district general hospitalBritish Journal of Surgery, 1981
- How accurately can direct and indirect inguinal hernias be distinguished?BMJ, 1980
- Femoral hernia: A recent appraisalBritish Journal of Surgery, 1971