Timing of strangulation in adult hernias.
This retrospective study aimed to determine why the incidence of strangulated hernias in adults remains high. Seventy-nine patients presented with clinical evidence of hernia strangulation which required urgent surgery during the period 1979-87. Forty-six patients (58 per cent) had noted a hernia present for at least 1 month before strangulation: 18 (23 per cent) had not reported it to their family doctor, 19 (24 per cent) were known by family practitioners or non-surgical medical personnel to have a hernia but had not been referred for surgical opinion, and nine (11 per cent) had been previously assessed surgically with a view to elective repair. Of these nine, five were considered unfit, three were on waiting lists for operation and one had refused surgery. Thirty-two patients (40 per cent) presented primarily with strangulation within days of developing a hernia. The duration of hernia before strangulation in one patient was unknown. Although an unavoidable number of patients will continue to present with strangulation within days of developing a hernia, the overall incidence could be significantly reduced by greater public awareness of the risks of hernia strangulation and by a policy of immediate patient referral and prompt elective repair.
Department of Surgery, Regional Hospital, Dooradoyle, Limerick, Ireland.
G P
GP
McEntee
A
A
O'Carroll
B
B
Mooney
T J
TJ
Egan
P V
PV
Delaney
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006547:Hernia / Q000209:etiology / Q000473:pathology; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors