External strangulated hernia in Khartoum, Sudan

To determine the pattern of presentation and outcome of strangulated external hernia, to predict the risk factors of strangulation, and to draw the attention towards the incidence of strangulation and its sequelae which are preventable by early repair.

A prospective study over a two year period.

Khartoum Teaching Hospital, Casualty Department during the period May 2002 to May 2004.

Sixty four patients with strangulated external hernias.

The mean age was 42 years and the age range was between 0.5-72 years. The male: female ratio was 5:1 and males dominated all types of hernia except in incisional hernia where more females were noted. Strangulated inguinal hernia was the most common type in 35 patients, being more common on hernias of a relatively short history (<1 year). Pre-strangulation symptoms like change in size, irreducibility and pain were reported by 57 (90%) patients few days to few weeks prior to strangulation. More than half of the patients presented to the hospital 24 hours after developing the symptoms. All patients were surgically explored, 52 through an inguinal incision and 12 via formal laparotomy. The total number of bowel resection was 24 (37.5%), mainly in those presenting after 48 hours and 12 of them were between the age of 51-60 years. There were four (6.25%) deaths.

Early diagnosis of patients with hernia and elective surgical treatment may offer the best way to minimise the relatively high morbidity and mortality associated with emergency operations.