Inguinal hernia and hernia repair in adults: the disease as seen at Kenyatta National Hospital over a five year period

Abstract

This is a retrospective study of all adult patients with inguinal hernia who were admitted at the Kenyatta National Hospital, Nairobi, over a five year period, between January, 1980 and December, 1984.

A total of 302 adult patients were included in this study. The relative sex incidence showed that the number of cases of inguinal hernia in this study were predominantly males, 296 males were seen compared with 6 females, giving a male to female ratio of 49:1. Majority of the patients were between the second and fifth decade of life.

Indirect inguinal hernia was the most common of all form of hernias studied. There were 93.4% cases of indirect inguinal hernia and 6.6% cases of direct inguinal hernia. Most of the hernias occurred on the right side (65.9%) than on the left side (24.1%). 9.3% occurred as bilateral inguinal herna. 80.1%

of the patients presented with reducible hernia, 0.7% as irreducible hernia, 9.3% as obstructed and 9.9% as strangulated, of all cases of strangulated inguinal hernia only one was direct.

Some patients presented with pin-pointing predisposing causes of inguinal hernia. 16 male patients presented with history of straining at micturation and were found to have enlarged prostate.

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5 patients had history of chronic cough out of which 4 were proven cases of pulmonary tuberculosis which had been adequately treated. 2 patients had history of straining at stool.

The patients were admitted to hospital as either cases of elective hernia repair or emergency surgery. 92.7% of the cases seen underwent surgery. 7.3% were treated conservatively and had been booked for surgery after the period of this study. 74.8%

of the patients had elective hernia repair and 17.9% had emergency surgery.

The type of hernia repair recorded was simply described as Bassini repair. The type of suture material used was not indicated in operation notes. The patients with bilateral hernias had both hernias reparied at the same time. 77.8% of the patients

who underwent emergency surgery had viable gut and 22.2% had gangrenous gut which resulted in resection and anastomosis.

Only 4 patients had surgery under local anaesthesia. The rest of the patients had general anaesthesis.

Surgical complications included scrotal oedema and

hematoma in 1.0% and wound infection in another 2.0%. 1 patient had testicular atrophy.