Emergency inguinofemoral hernia. Have we improved over the years?

Abstract

Introduction: The hernia of the inguinocrural region is a very frequent pathology and a reason for common consultation in the emergency services, with high morbidity and mortality rates. The objective of this study is to evaluate the results of inguinocrural hernia management as an urgent process and its current morbidity and mortality rates. Material and methods: Retrospective study on a prospective database of patients undergoing emergency surgery for inguinal hernia between 2004 and 2015, inclusive. Clinical, diagnostic and treatment variables are collected. Results: Of 249 patients who were operated on urgently for inguinal hernia, with a mean age of 74 years, 151 (60.6 %) were inguinal hernias and 98 (39.4 %) were inguinal hernias. The most common reason for consultation was the inguinal tumor (41.8 %), followed by the intestinal obstruction (30.1 %). The duration of symptoms was 24 hours; diagnostic time 2 hours; and the time to the operation of another 2 hours. 25.7 % had no description of the exploration of the inguinal region, and of these, 90 % had an abdominal x-ray and 47 % had an abdominal-pelvic CT scan. Intestinal resection was necessary in 38 patients (15.3 %). One-third of all patients had some type of complication, with a mortality rate of 5.2 %. Morbidity and mortality were related to factors such as age, ASA (American Society of Anesthesiologists), time to diagnosis and the need for intestinal resection. Conclusion: The morbimortality of urgent surgery of the inguinal hernia is still high. The results could be improved by an early and adequate physical examination.