Emergency Presentation of Groin Hernia: Severity and Outcomes of Treatment in a Nigerian Tertiary Hospital.

BACKGROUND AND OBJECTIVE Complications arising from groin hernias carry significant risks that task the resources of the surgeon and patient and, whenever feasible, should be avoided. In the past, obstructed groin hernia was the most common cause of intestinal obstruction in many parts of tropical Africa, but the trend appears to be changing. The aim of this study was to determine the severity and operative outcomes of complicated groin hernias in our centre. DESIGN Aseven-year retrospective study. SUBJECTS Records of adult patients with groin hernias, managed surgically for complicated groin hernias from January 2012 to December 2018 were retrieved and evaluated. RESULTS A total of 387 patients were evaluated representing 18.3% of the entire groin hernias repaired surgically during the study period. Inguinal hernias accounted for 88.4% while femoral hernias represented 11.6%. Majority (76.5%) resided in a rural area. Twenty six (6.7%) patients presented with bilateral hernias (all were inguinal), but none had complications in both groins simultaneously. Twenty-one (5.4%) patients had spontaneous reduction, and of these, 13 (61.9%) received mesh implants. Overall, 6.2% were incarcerated, 56.8% were obstructed while the remaining 37.0% were strangulated. The resection rate was 29.5% for emergency repairs; 60.2% of the resections were performed in those who delayed beyond 72hours before presentation. The overall morbidity and mortality rates were 40.7% and 10.4% respectively. CONCLUSION Late presentation is very common among patients with complicated inguinal hernia in our centre. Subsequently, bowel resection, morbidity and mortality rates are increased in proportion to the length of delay and degree of bowel and systemic involvements.