GIANT INGUINAL HERNIA

COMPLICATIONS AND THEIR MANAGEMENT IN PATIENTS

Abstract

Objectives: To determine the complications and their management in patients
with giant inguinal hernia. Place and Duration of Study: This study was carried out in in
Surgical Unit-IV, Liaquat University Hospital Jamshoro, from October 2013 to December 2015.
Methodology: This study consisted of 30 patients of giant inguinoscrotal hernias. Detailed
History was taken from all the patients with special regard to the inguinoscrotal swelling.
Detailed Clinical examination of the patient was done .Site of swelling was especially examined
for assessment of three grades. Grade–I means hernia reaching upto middle of thigh, Grade-II
means inguinoscrotal contents reaching upto knee joint and Grade-III means contents going
below knee level. All data was entered in a specified proforma designed for this purpose.
Inclusion criteria were all diagnosed patients of giant inguinoscrotal hernia on the basis of
history, clinical examination were included in this study. Exclusion criteria included patients
unfit for surgery, patients below age of 12 years, patients with severe co-morbidity and morbid
obese patients. Results: 30 patients included in this study. There was wide variation of age
ranging from a minimum of 30 years to 70 years , mean age was 46.28+7.20 years. The patients
presented with more common in right side 21(70%) cases and left side 9(30%) cases. Patients
presented with grade-I 11(36.66%) cases, grade-II 9(30%) cases, grade-III 7(23.33%) cases and
grade IV 3(10%) cases. Giant inguinal hernia were operated Orchidectomy and hernioplasty
12(40%) cases, followed by Debulkation of contents and hernioplasty 9(30%) cases and
Gradual Pneumoperitoneum and hernioplasty 4(13.33%) cases. Complications seen in this
study was Respiratory in 3(10%) patients, Abdominal compartmental syndrome in 1(3.33%)
patients, Paralytic Ileus in 2(6.66%) patients and Wound Infections in 4(13.33%). Conclusion:
In conclusion our study revealed it is commonly to live in our population due to ignorance of
hernia poverty in remote areas and lack of knowledge of disease complications.