Morbidity and Mortality Associated with Inguinal Hernia in Northwestern Nigeria

Background: Treatment of uncomplicated inguinal hernia is relatively simple and the outcome is often favourable. Complicated hernias are fraught with increased mortality with and without operative management.

Objective: To determine the scope of adverse events which attend the management of inguinal hernia in extreme northwestern region of Nigeria.

Methods: Subjects. From the hospital records department, the case folders of all patients with the clinical diagnosis of hernia seen between January 2000 and December 2002 were retieved. Of the cases identified, 227 patients diagnosed of inguinal hernia, either alone or in combination with other forms of hernia formed the basis of this report. Relevant data extracted and analyzed included the patient's demographics, clinical details, treatment offered and outcome.

Results: Two hundred and fifty three inguinal hernias in 227 individuals were seen.. This represented 76.9% of patients diagnosed of external abdominal hernias., 16 times more commonly in males than females. Fifty two (20.6%) hernias presented as acute abdominal emergencies while 225 hernias in 199 patients were repaired. Local anesthesia was used in 32 (16.1%) of the patients with 33 (14.7%) inguinal hernias. Four (1.8%) individuals were managed on day case basis. Twelve (5.3%) deaths occurred in this series, three of which were pre-operative. At a mean follow up of 7 months (range 1-23 months), 1 (0.4%) hernia recurrence was noted.

Conclusion: Complicated inguinal hernias and their emergency surgical treatment are associated with increased mortality in our environment. Prophylactic elective herniorrhaphy is recommended as a safeguard for inguinal hernia as soon as identified irrespective of patient's age.