[Strangulated groin hernia still frequent in tropical milieu]

This study aimed to describe the epidemiological, clinical, therapeutic and postoperative data of strangulated groin hernia. Details of consecutive adults patients admitted to our emergency wards for strangulated groins hernia and operated on from august 1998 to december 2007 were recorded. In addition the mode of presentation, hernia type, treatment and outcome were also recorded for each case. The statistical analysis used the Chi2 test and the Fischer test. 149 strangulated groin hernias were recorded in 135 men and 14 women. Inguinal hernias were seen in 143 patients and femoral hernia in 6. Median age was 40 years. The mean delay for consultation was 2 days. Richter hernia, Maydl hernia and hernia abscess were seen in eight, two and three cases each. Bowel resection was required in 30 patients. Inguinal hernia underwent Bassini's procedure, Shouldice procedure and Mac Vay's procedure. While femoral hernia underwent only Mac Vay's procedure. No hernia repair was undergone in hernia abscess. Mortality was 10%. Bowel necrosis, long duration of symptoms, ASA class, bowel resection and strangulated groin hernia with hernia abscess, peritonitis and occlusion were found to be significant factors linked with unfavorable outcome. Morbidity was 16.7% and required reoperation in 9 patients; sepsis and hematoma were the most frequent complication. In conclusion, strangulated groin hernia still remain a frequent matter of consultation in visceral ward in tropical milieu. The high morbidity and mortality rate are unacceptable because of the possibility of avoiding them by early consultation and elective repair of groin hernia.