Femoral Hernia: Epidemiology and challenges of management in a sub-saharan African Country

Authors

  • Aloysius Ugwu-Olisa Ogbuanya Consultant Surgeon, Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abalaliki (AEFUTHA), PMB 102, Ebonyi State, Nigeria Lecturer, Department of Surgery, Ebonyi State University, Abakaliki (EBSU), Ebonyi State, Nigeria, Consultant Surgeon, Department of Surgery, Bishop Shanahan Specialist Hospital, Nsukka, Enugu State, Nigeria, Consultant Surgeon, Department of Surgery, Mater Misericordiae Hospital, Afikpo, Ebonyi State, Nigeria http://orcid.org/0000-0002-1046-8593
  • Fabian Ugonna Olisa Consultant Surgeon, Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abalaliki (AEFUTHA), PMB 102, Ebonyi State, Nigeria https://orcid.org/0000-0002-5510-5825
  • Richard Lawrence Ewah Lecturer, Department of Surgery, Ebonyi State University, Abakaliki (EBSU), Ebonyi State, Nigeria Consultant Anaesthetist, Department of Anaesthesia, Alex Ekwueme Federal University Teaching Hospital, Abalaliki (AEFUTHA), PMB 102, Ebonyi State, Nigeria,  Consultant Anaesthetist, Department of Anaesthesia, Mater Misericordiae Hospital, Afikpo, Ebonyi State, Nigeria https://orcid.org/0000-0002-4208-7576
  • Obinna Nweke Senior Resient, Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abalaliki (AEFUTHA), PMB 102, Ebonyi State, Nigeria https://orcid.org/0000-0001-5282-0885
  • Nonyelum Benedett Ugwu Nursing Officer, Department of Nursing, Bishop Shanahan Specialist Hospital, Nsukka https://orcid.org/0000-0002-9432-9792

DOI:

https://doi.org/10.3126/ajms.v11i6.30368

Keywords:

Femoral hernia, Mesh plug, Strangulation, Mortality, Resection

Abstract

Background: Femoral hernia is peculiar due to its high propensity towards strangulation, high rates of diagnostic pitfalls and occurrence in older patients with multiple comorbidities. Therefore, an updated record of the clinical characteristics and burden of the disease in our locality should be established.

Aims and Objectives: This study aimed to document the challenges of diagnosis and outcome of repair of femoral hernia in southeast Nigeria.

Materials and Methods: This was a multi-centre retrospective study of adult patients with femoral hernias repaired surgically over twelveyears period. Tests of statistical significances were done.

Results: A total of 128 patients were studied and they represented 3.4% and 2.6% of all patients with groin and abdominal wall hernias respectively. There were 116 females and 12 males. The overall rate of missed diagnosis was 14.8%; majority (84.2%) were in the emergency arm. Eighty-one (63.4%) patients presented emergently while 47 (36.7%) were managed electively. In the emergency group, the vast majority (72, 88.9%) presented beyond 24hours from onset of complications. Still on the emergency group, 72 (88.9%) were strangulated, seven (8.6%) were obstructed and 2 (2.5%) were incarcerated at presentation. Overall resection rate was 39.8%, but in the emergency group, it was 63.0%. Prosthetic meshes were used in only 4 (8.5%) of the 47 elective cases. Recurrence rate was Overall morbidity and mortality rates were 43.0% and 10.9% respectively. Late presentation was an independent predictor of mortality (p=0.000).

Conclusion: Though femoral hernias are relatively uncommon, the rate of missed diagnosis is high, majority of which occur in the emergency group. Majority presented in emergency and have high propensity towards strangulation with attendant high morbidity and mortality.

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Published

2020-11-01

How to Cite

Ogbuanya, A. U.-O., Olisa, F. U., Ewah, R. L., Nweke, O., & Ugwu, N. B. (2020). Femoral Hernia: Epidemiology and challenges of management in a sub-saharan African Country. Asian Journal of Medical Sciences, 11(6), 77–83. https://doi.org/10.3126/ajms.v11i6.30368

Issue

Vol. 11 No. 6 (2020)

Section

Original Articles

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