title: [Presentation and outcome of incarcerated external hernias in adults].
abstract: OBJECTIVE
  The aim of this study was to determine the clinical presentation and outcome of incarcerated external hernias in adults, as well as to identify the factors that might have some influence on outcome.
  
  
  METHODS
  A retrospective study of 230 adult patients who underwent emergency surgical repair of incarcerated external hernias from 1992 to 2001 was performed. The characteristics of clinical presentation, type of anesthesia, surgical procedures, complications and mortality were studied. To determine clinical factors that might have some influence on outcome, an univariate analysis was also performed.
  
  
  RESULTS
  There were 77 femoral hernias, 70 inguinal, 43 umbilical and 40 incisional hernias. Seventy-four patients (32.2%) presented after 48 h of symptom onset. Significant associated diseases were found in 135 patients (58.7%). General anesthesia was used in 140 patients (60.9%), spinal anesthesia in 86 patients and local anesthesia in four patients. The most commonly used procedures were anatomic repair and tension-free hernioplasty. Bowel resection was required in 31 patients (13.5%). Overall and major morbidity and mortality were 37.8%, 10% and 3.9%, respectively. Factors that were significantly associated with unfavorable outcome were longer duration of symptoms, late hospitalization, concomitant diseases, and a high ASA class.
  
  
  CONCLUSIONS
  External hernias produce elevated morbidity and mortality if treatment is undertaken as an emergency. Thus, early diagnosis and elective repair of uncomplicated hernias should be performed in adults.
authors.affiliation: Servicio de Cirugía General, Hospital San Agustín, Avilés, Asturias, Spain. josealvar@telecable.es
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Alvarez-Pérez
authors.forename: Ricardo Francisco
authors.initials: RF
authors.lastname: Baldonedo-Cernuda
authors.forename: Isabel
authors.initials: I
authors.lastname: García-Bear
authors.forename: José Armando
authors.initials: JA
authors.lastname: Suárez-Solís
authors.forename: Paloma
authors.initials: P
authors.lastname: Alvarez-Martínez
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Jorge-Barreiro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046449:Hernia, Abdominal / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome