Femoral hernia: intestinal obstruction is an unrecognized source of morbidity and mortality

Abstract

A total of 180 consecutive femoral hernia repairs, consisting of 100 emergency and 80 elective admissions between January 1979 and December 1986, were reviewed. Morbidity was greater in the emergency than in the elective group (P <0·01) and was significantly related to intestinal obstruction (P <0·001), a feature not previously highlighted. Intestinal obstruction also had an important association with mortality, which was confined to patients undergoing emergency surgery. Patients with intestinal obstruction are a high-risk group and require careful perioperative management. Wound infection predisposed to recurrence of femoral hernia (P <0·01). Repair of recurrent hernia in patients treated electively was associated with an increased incidence of chest infection (P <0·001). Prophylactic measures, including antibiotics, may help to reduce recurrence and its associated morbidity. Patients referred with an inguinal lump or hernia, as opposed to a femoral hernia, had a later outpatient appointment and consequently a later operation date (P <0·02). All elderly patients referred with any groin lump should receive an early outpatient appointment.