The Pattern Of Adult External Abdominal Hernias In Zaria

Abstract

Over a period of 12 years seven thousand, nine hundred and fifty-two (7952) patients with general surgical problems were operated on at the Ahmadu Bello University Teaching Hospital, Zaria. Of these, patients with external abdominal hernias constituted nine hundred and eighteen (918). Operation for hernias constituted about 12.5% of the operative work-load of the general surgeons in this hospital. The descending order of occurrence of external abdominal hernias were inguinal, femoral and incisional. Right inguinal hernias were commoner than left inguinal hernias with a ratio of 1.7:1. The indirect inguinal hernias accounted for 67.5% of cases of inguinal hernias. There were fifty (50) of cases of bilateral inguinal hernias. Femoral hernias were commoner in the female patient than in the males, though inguinal hernias will still the commonest hernias in the females. Generally speaking, femoral hernias were commoner on the left side than on the right side. Incisional hernias occurred in women following caesarean section for obstructed labour. The commonest mode of presentation in all hernias was a reducible simple hernia. Other modes of presentation included irreducible hernia, intestinal obstruction, intestinal strangulation with peritonitis and occasional giant hernias (fascial deflect diameter greater than 10cm). Femoral hernias obstructed more commonly than inguinal hernias. Modified Bassini repair was the method employed to repair the inguinal hernias, low approach for simple femoral hernias and high approach for complicated femoral hernias. Simple repairs also were employed for incisional hernias with Keel method for moderate-to-giant hernias (facial deflect > 10cm in diameter). Four patients died, three from overwhelming infection following strangulation obstruction of inguino-scrotal hernias and one from severe chest infection following repair for a giant incisional hernia. The follow up was poor. Most patients defaulted after their second visit to surgical out patient department . External abdominal hernias remain a significant surgical problem in our environment.(Nig J Surg Res 2000; 2:12-15) KEY WORDS: External abdominal hernia, Adults, Morbidity, Mortality