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A clinical study of complicated inguinal hernias

Background: Hernia is a common, treatable condition, if ignored can lead to life- threatening complications. Lack of health awareness, poverty, and lack of surgical facilities will lead to devastating complications. This study aims at illustrating the various modes of presentation, management and postoperative outcome in complicated inguinal hernias.Methods: 50 patients of complicated inguinal hernia admitted in Basaveshwar Teaching and General Hospital attached to M.R. Medical College, Kalaburagi from September 2016 to August 2018 was studied.Results: 12 cases (24%) presented within 24 hrs of onset of symptoms, while 38 cases (76%) after 24 hrs. 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 1 side. 44% 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 were from urban areas. Most common age of presentation was 4th and 5th decade. Most common mode of presentation was an irreducible swelling (100%), followed by pain in 48% and vomiting in 46% cases. The content was small bowel in 54% cases, omentum in 18% cases and both in 16% cases. Herniorrhaphy was performed in 74% cases and hernioplasty in 14%. 6 cases of strangulated hernia with non-viable bowel underwent resection and anastomosis. 3 deaths (6%) were reported.Conclusions: Patients who presented within 24 hours of onset of symptoms had shorter hospital stay, lesser complications and no mortality. Whereas cases presented after (>24 hrs) had higher rate of complications and mortality. Most of the complicated cases were from rural area and were right sided indirect inguinal hernias.