Anterior abdominal wall hernias in a rural practice in Rivers State, Nigeria

Abstract

Background: Abdominal wall hernias constitute the most common of all surgical problems and can be fatal when complicated.

Aim: To determine the pattern of presentation of anterior abdominal wall hernias in a rural community in Rivers State of Nigeria.

Methods: The study was conducted in Bethesda Clinic, a rural clinic in Rivers State of Nigeria. Medical records of all patients who presented with abdominal wall hernia from January 1997 to December 2001 were reviewed. The information retrieved were analyzed using the Statistical Package for Social Sciences version 11.

Results: Of the 128 patients with abdominal wall hernias, 93 were males while 35 were females, giving a male to female ratio of 2.7:1. Their age range was 17-97 years (mean 46.2 ± 14.3 years). Over 90% of the patients were in the 15-64 years age bracket.  Obstruction occurred in 13 (10.2%) of the patients. Eleven (84.6%) patients had obstructed inguinoscrotal hernia and two (both females) had obstructed umbilical hernia.  Eight patients (61.5%) presented after 24 hours of onset of obstruction, five (62.5%) of which had bowel resection. The postoperative complications included wound infection and scrotal haematoma and the average stay in hospital was 10.5 ± 3.2 days. Fishing occupation was significantly associated with obstruction (p=0.007). The duration of obstruction before presentation was also significantly associated with bowel resection (p=0.05). There was no mortality.

Conclusion: Herniation occurred mainly in the productive age group. Occupation (fishing) was significantly associated with obstructed hernia among rural dwellers in Rivers State of Nigeria.

Keywords: Anterior abdominal wall hernias, Obstruction, Bowel resection, Rural, Rivers State, Nigeria