CLINICAL STUDY AND MANAGEMENT OF VENTRAL HERNIAS IN ADULTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 4
Abstract
BACKGROUND Hernia is defined as abnormal protrusion of viscous through a normal or abnormal weakness in the wall of its containing cavity. Ventral hernias are the second most common type of hernias accounting for 21% to 35% of all varieties of hernias. Reported incidence of incisional hernias is 2% to 11%. It is the most common complication after laparotomy by a 2: 1 ratio over bowel obstruction and is the most common indication for reoperation by 3: 1 ratio over adhesive small bowel obstruction. This study was undertaken to study the various clinical presentation and management of ventral hernias. MATERIALS AND METHODS This is a prospective study. A clinical study of 50 cases of ventral hernia has been done during the period from December 2015 to September 2017, on inpatients admitted to Basaveshwar Teaching and General Hospital (BTGH) attached to Mahadevappa Rampure Medical College, Gulbarga. Data was collected according to proforma, which included detailed history, clinical examination and investigation. Data was tabulated, analysed and results interpreted. RESULTS Incidence of incisional hernias was more in females with male-to-female ratio of 1: 4, while epigastric and umbilical hernias were more common in males with male-to-female ratio of 3: 1 and 2: 1 respectively. Previous surgery was the single most important cause for ventral (Incisional) hernias. Other aetiological factors were multiparity, obesity, anaemia, BPH, alcoholic liver disease and COPD. Postoperative wound infection was the important cause for development of incisional hernias. Size of the defect and presence of complication are the guiding factors for choosing the type of repair. Mesh repair is the technique of choice for most of incisional hernias and for all ventral hernias with large defect. Though sublay/ underlay mesh placement is more physiological, it can be placed either inlay or onlay. CONCLUSION Ventral hernias are common surgical complaints. Prevention is the better treatment in the form of meticulous dissection and proper post-operative care. Presence of ventral hernia is an indication for surgery even in presence of co-morbid conditions like ascites, COPD and BPH, as these patients are more prone for complications and of course these conditions need proper addressal before hernia repair. Mesh repair has become the standard of care and laparoscopy is the approach of choice depending on the affordability of the patients and expertise of the surgeon.
Authors and Affiliations
Karbhari S. S, Umeshchandra D. G, Srikanth Marla Chintamani
Keywords
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- EP ID EP285860
- DOI 10.14260/jemds/2018/100
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