Title: Ignorance is not bliss- A neglected inguinal hernia with obstruction can lead to the eternal home

Authors: Dr K.Venkata Vigneswara Rao, Dr M. Ramachandra, Dr B Raviteza

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.124

Abstract

In our country, a large part of patients still neglects inguinal hernia due to the low level of public awareness about the danger of obstruction and strangulation.  Even with better pre and postoperative care, improved anesthetic management and advanced surgical techniques, the emergency repair of an obstructed hernia is associated with poor prognosis and a high rate of postoperative complications. This study is to assess various risk factors and therapeutic strategies for better outcome of the patients presented with an obstructed inguinal hernia at our setup. A total of 74 inguinal hernia patients with obstruction were evaluated. Majority of the patients were in the fifth and sixth decade. More than 50% of cases belong to low socio-economic strata, who do heavy work. Right-sided Indirect hernias were more common than others. Chronic cough, constipation, prostatic enlargement are common causes of increased intra-abdominal tension seen in more than 60% of cases. All of the cases were operated as an emergency procedure. Viable bowel was seen 75.46% of cases. Bowel resection and end-to-end anastomosis were done in all cases of nonviable bowel. Patients presented early with the only obstruction, had an excellent prognosis; But the danger group, where symptomatology is vague and associated with strangulation had a higher rate of complications and mortality.

Keywords: Inguinal Hernia, Intestinal Obstruction,Neglected Hernia, Bowel Resection

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Corresponding Author

Dr S. Ramachandra DNB.(Gen Surgery)

Associate Professor, Department of General Surgery, Govt. Medical College, RIMS, Kadapa, AP, India