[Strangulated groin hernias in adults: a survey of 228 cases]

Strangulation is the most complication of groin hernias in adults.

To report our experiment in the treatment of strangulated groin hernias and their presentation in adults.

It is a retrospective study carried out from January 1997 to June 2002, involving 228 patients operated for strangulated groin. Epidemiologic, clinical and therapeutic aspects were studied.

The average age of the patients was 45 years with extremes of 17 and 85 years. There were 220 men (96%) and 8 women (4%). Inguino-scrotal hernia was seen in 176 cases (77.2%), inguinal hernia in 46 cases (20.1%), and femoral hernia in 6 cases (2.7%). The hernia seat on the right side in 145 cases (63.6%) and on the left side in 83 cases (36.4%). The average duration of symptoms was 24 hours. Elective oblique kelotomy was realised in 140 cases (61.4%), elective transversal kelotomy in 87 cases (38.2%) and median laparotomy in 1 case (0.4%). Bowel resection is required in 16 cases (7%). Bassini procedure was carried out in 158 cases (69%) and modified Mac Vay procedure in 70 cases (31%). The average duration of hospital stay was 3.6 days. One death (0.4 %) caused by cardiopathy was noted. The morbidity rate was 8.3% (19 cases). Those following complications were noted: bowel injury (2 cases), caecal injury (1 case), bladder injury (1 case), wall abscess (5 cases), post-operative pain (5 cases), late transit restart (2 cases) and scrotal haematoma (3 cases). On 108 patients (47.4%) followed regularly with a median follow-up period of 42 months, 8 cases (7.4%) of recurrence were noted.

In our survey, the mortality rate is very low, the rate of bowel resection is low, and the morbidity rate is negligible. Despite the current tendency to use prosthetic mesh in emergency, traditional procedure in particular Bassini procedure gives good results with an acceptable rate of recurrence in a short and medium follow-up period.