title: Acutely incarcerated abdominal wall hernia: what if it is a consequence?
abstract: OBJECTIVE
  The aim of this study was to emphasize the importance of differential diagnosis in patients with acutely incarcerated abdominal wall hernia (AWH).
  
  
  METHODS
  The medical records of patients who underwent emergency surgery with preoperative diagnosis of acutely incarcerated AWH and in whom acutely incarcerated AWH was the consequence of increased intraabdominal pressure due to other abdominal emergencies were reviewed. The following data were collected: demographics, the duration between the onset of symptoms and admission, clinical findings, biochemical test results that were abnormal, radiological findings, preoperative and intraoperative diagnosis, operative findings, surgical procedure, different diagnosis made in the postoperative period, reoperation, morbidity, mortality, and the length of hospital stay.
  
  
  RESULTS
  Ten patients were included to the study. The primary pathology was found to be perforated peptic ulcer disease in three, bowel obstruction due to neoplastic mass in three, complicated appendicitis in two, acute mesenteric ischemia in one, and acute diverticulitis in one. The correct diagnosis was made during emergency surgery for hernia repair, whereas the primary pathology was identified postoperatively in two patients.
  
  
  CONCLUSIONS
  Patients who are diagnosed to have acutely incarcerated AWH preoperatively should undergo further diagnostic workup, if any level of clinical suspicion for differential diagnosis is present. Moreover, the surgeon should consider general abdominal exploration if contradictory findings are encountered during the exploration of the hernia sac, even if preoperative diagnostic studies reveal no gross pathology or non-specific findings.
authors.affiliation: Genel Cerrahi Klinigi, Dr. Sadi Konuk Egitim ve Arastirma Hastanesi, Bakirkoy, 34147, Istanbul, Turkey, gonencmd@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Gonenc
authors.forename: M A
authors.initials: MA
authors.lastname: Bozkurt
authors.forename: S
authors.initials: S
authors.lastname: Kapan
authors.forename: A
authors.initials: A
authors.lastname: Aras
authors.forename: A
authors.initials: A
authors.lastname: Surek
authors.forename: H
authors.initials: H
authors.lastname: Alis
mesh_terms: D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D005260:Female; D005767:Gastrointestinal Diseases / Q000145:classification / Q000150:complications / Q000175:diagnosis; D006552:Hernia, Inguinal / Q000503:physiopathology / Q000601:surgery*; D006555:Hernia, Ventral / Q000503:physiopathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D033162:Incidental Findings; D007415:Intestinal Obstruction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D014421:Turkey