Complicated Scott N. Oishi,
MD,
Presentations
Carey P. Page,
MD, FACS,
Wayne
Elective repair of simple (uncomplicated) inguinal and femoral hernias avoids incarceration and bowel obstruction (complicated presentations). To identify factors that perturb this strategy, we analyzed the records of 1,859 consecutive nonpediatric patients with groin hernias. Incarceration or bowel obstruction prompted operation in 22 of 77 (29%) women and in 15 of 34 (44%) patients with femoral hernia. Patients presenting with bowel ohstmction were significantly older than those with incarceration only and/or uncomplicated presentation, and 13 of 25 (52%) required resection of necrotic bowel. Mortality was limited to five patients of advanced age with groin hernia and bowel obstruction. Four of the five patients had undergone resection of necrotic bowel. Complicated presentations of groin hernias are associated with a higher proportion of women and patients with femoral hernias. Gangrenous bowel was encountered only in those patients with groin hernia and bowel obstruction. Early diagnosis and elective repair of uncomplicated hernias should remain our strategy in patients of all ages.
of Groin Hernias H. Schwesinger,
MD,
FACS, sari Antonio,TWS
lective repair of inguinal and femoral hernias is E safe and effective strategy that avoids incarceratic and strangulation and their complications. The adva tages of early elective repair are most evident in childrc under the age of 3 in whom the morbidity and mortali of untreated groin hernia are impressive. Application this approach, however, is dependent on accurate diagn sis of the hernia and on both the surgeon and the patie being amenable to elective repair. Review of our rece experience with nonpediatric groin hernias indicates th factors that either delay the diagnosis of groin hernias that contribute to deferral of definitive elective operatic are associated with more complicated presentations. PATIENTS
AND METHODS
We analyzed the records of patients aged 15 years ai older undergoing repair of groin hernias between M; 1982 and May 1990 at our two teaching hospitals. T1 presentations of those without incarceration presenti for elective repair were categorized as “simple” or “u complicated.” “Complicated” presentations were dividl into two groups, those presentations with incarceratic and those presentations with bowel obstruction. Observ tions recorded for each patient included the type of PI sentation, age, gender, location of the groin hernia, cox plications, outcome, and length of hospitalization. Da analysis for three-group comparisons used analysis variance for continuous data and chi-square for discre observations with p
MD,
Presentations
Carey P. Page,
MD, FACS,
Wayne
Elective repair of simple (uncomplicated) inguinal and femoral hernias avoids incarceration and bowel obstruction (complicated presentations). To identify factors that perturb this strategy, we analyzed the records of 1,859 consecutive nonpediatric patients with groin hernias. Incarceration or bowel obstruction prompted operation in 22 of 77 (29%) women and in 15 of 34 (44%) patients with femoral hernia. Patients presenting with bowel ohstmction were significantly older than those with incarceration only and/or uncomplicated presentation, and 13 of 25 (52%) required resection of necrotic bowel. Mortality was limited to five patients of advanced age with groin hernia and bowel obstruction. Four of the five patients had undergone resection of necrotic bowel. Complicated presentations of groin hernias are associated with a higher proportion of women and patients with femoral hernias. Gangrenous bowel was encountered only in those patients with groin hernia and bowel obstruction. Early diagnosis and elective repair of uncomplicated hernias should remain our strategy in patients of all ages.
of Groin Hernias H. Schwesinger,
MD,
FACS, sari Antonio,TWS
lective repair of inguinal and femoral hernias is E safe and effective strategy that avoids incarceratic and strangulation and their complications. The adva tages of early elective repair are most evident in childrc under the age of 3 in whom the morbidity and mortali of untreated groin hernia are impressive. Application this approach, however, is dependent on accurate diagn sis of the hernia and on both the surgeon and the patie being amenable to elective repair. Review of our rece experience with nonpediatric groin hernias indicates th factors that either delay the diagnosis of groin hernias that contribute to deferral of definitive elective operatic are associated with more complicated presentations. PATIENTS
AND METHODS
We analyzed the records of patients aged 15 years ai older undergoing repair of groin hernias between M; 1982 and May 1990 at our two teaching hospitals. T1 presentations of those without incarceration presenti for elective repair were categorized as “simple” or “u complicated.” “Complicated” presentations were dividl into two groups, those presentations with incarceratic and those presentations with bowel obstruction. Observ tions recorded for each patient included the type of PI sentation, age, gender, location of the groin hernia, cox plications, outcome, and length of hospitalization. Da analysis for three-group comparisons used analysis variance for continuous data and chi-square for discre observations with p
