A CLINICAL STUDY OF COMPLICATED INGUINAL HERNIAS

<p><strong>Background and objectives: </strong>Hernia is a common, simple and easily treatable condition, yet, if ignored can lead to life- threatening complications. Lack of health awareness, poverty, and paucity of surgical facilities result in neglecting the condition for a long period of time. The patient ultimately approaches the emergency department with devastating complications. This study aims at illustrating the various modes of presentation, management and post-operative outcome in complicated inguinal hernias.</p> <p><strong>Methods:</strong> The material for this study was collected from the patients of complicated inguinal hernia admitted in the Surgical Department of Basaveshwar Teaching and General Hospital attached to M.R. Medical College, Kalaburagi from September 2015 to August 2017.</p> <p><strong>Results:</strong> In this study, 50 cases of complicated inguinal hernia were studied. Among them 12 cases (24%) presented within 24 hours of onset of symptoms, while 38 cases (76%) after 24 hours. Only 1case was female. 32 cases (64%) were right sided and 16 cases (32%) were left sided hernias. 2 cases (4%) were bilateral hernias but had complication on only one side (right side in both the cases). 44% of cases were irreducible, 36% were obstructed and 20% were strangulated. 96% cases were indirect while only 4% were direct hernia. 82% cases were from rural and 18% cases th th from urban areas. Most common age of presentation was 4 and 5 decade. Most common mode of presentation was an irreducible swelling (100%), followed by pain in 48% and vomiting in 46% cases. Small bowel was the most common content of the sac, seen in 54% cases, followed by omentum in 18% cases and small bowel with omentum in 16% cases. Most common surgery performed was herniorrhaphy in 74% cases followed by hernioplasty in 14% .There were 6 cases of strangulated hernia with non-viable bowel which underwent resection and anastomosis. There were 3deaths (6%), all of them were late presented cases.</p> <p><strong>Conclusion: </strong>Patients who presented within 24 hours of onset of symptoms had mild clinical presentation, shorter hospital stay, lesser complications and no mortality. Whereas late presented cases (&gt;24hrs) had a more severe presentation, prolonged hospital stay, higher rate of complications and mortality. Most of the complicated cases were right sided and indirect inguinal hernias, and in male patients. Patients from rural areas were found to have higher number of complicated cases than urban areas.</p>