Anterior Abdominal Wall Hernia in Women

Malarvizhi, Chandrasekaran (2007) Anterior Abdominal Wall Hernia in Women. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: Hernia is a protrusion of a viscus or part of a viscus through an abnormal opening in the walls of its containing cavity. The external Abdominal Hernia is the commonest form. The most frequent types are Inguinal, Femoral, Umblical, Paraumblical, Epigastric and Incisional Hernia. Although Hernia is more common in men, women are also is susceptible to hernia. There is very little published information relating specifically to hernia in women. The following discussion aims to shed light on the different types of hernia in women, mode of presentation,treatment options and outcome. AIMS OF STUDY: 1. To determine the incidence of various types of hernia in women and the most common hernia occurring in women. 2. To find the common Predisposing factors for hernia in women and determine prevention strategies. 3. To determine the Age Distribution of Hernia in Women. 4. To decide on the Best form of Treatment. 5. To find out the Morbidity and Mortality of Hernia surgery in women. MATERIAL AND METHODS: This is a retrospective study of Inpatients in the department of Surgery at KMCH Chennai during the period April 2003 to May 2006. The inpatients chosen in this study were all adult women above 15 years. They presented with various types of external Abdominal Hernia. Patients admitted for both Elective and Emergency surgery were included in this study. PROFORMA: Name, Age, Sex, IP Number. PRESENTING COMPLAINTS: 1. Pain, 2. Lump in the Abdomen, 3. Intestinal Obstruction, 4. Irreduciblity of the Lump. HISTORY OF PRESENTING COMPLAINTS: PAST HISTORY: 1. Comorbid illness. 2. Nature of Previous surgery. PERSONAL HISTORY, MENSTRUAL HISTORY, OBSTETRIC HISTORY, FAMILY HISTORY, TREATMENT HISTORY, HISTORY OF DRUG ALLERGY, GENERAL EXAMINATION: 1. Height, 2. Weight, 3. Body Mass Index, 4. Build. VITAL SIGNS: 1. Temperature, 2. Pulse Rate, 3. Blood Pressure, 4. Respiratory Rate. LOCAL EXAMINATION: 1. In Standing and Supine Position, 2. Inspection, 3. Site of Pain or Lump, 4. Characteristics of the Lump, 5. Palpation, 6. Percussion, 7. Auscultation. SYSTEMIC EXAMINATION: 1. Respiratory System, 2. Cardiovascular System, 3. Nervous System, 4. Spines, 5. Cranium. INVESTIGATIONS: 1. Haemogram, 2. Urine Routine Analysis, 3. Blood Urea, 4. Blood Sugar, 5. Serum Creatinine, 6. Serum Electrolytes, 7. Chest X Ray, 8. Abdomen X Ray, 9. ECG, 10. Ultra Sound Abdomen. DIAGNOSIS, SURGERY, OUTCOME. SUMMARY: 1. The different types of hernia encountered in women in our study were Incisional hernia; Paraumbilical hernia, Umbilical hernia, Epigastric hernia, Inguinal hernia and Femoral hernia. 2. The commonest type of hernia in women was incisional hernia following lower abdominal surgery. Since linea alba is poorly developed below the umbilicus and posterior retus sheath is deficient below linea semilunaris of Douglas, they are more prone for incisional hernia. The most common previous surgery was an emergency lower section Caesarian section. 3. Common predisposing factor for incisional hernia was obesity and wound infection. The reason being fatty tissue infitrate muscle fibres causing slackening during contraction. 4. Other than incisional hernia, paraumbilical hernia was the next most common hernia. 5. The commonest age group affected by hernia was the reproductive age group (15-44 years). But paraumbilical hernia was more common in the postmenopausal age group. Femoral hernia was also more common in the older age group. 6. The best form of treatment is mesh repair in incisional hernia, and anatomical repair in all other hernia. 7. The morbidity in our series was 20.6% with wound infection being the commonest cause. The recurrence rate was 1.2% which is much less than that reported in other series. Mortality in our series was 0.6%. 8. Strategies to prevent hernia in women are weight reduction, proper aseptic surgical technique, appropriate, non absorsbable suture material and tension free sutures in case of incisional hernia. 9. The morbility and mortality associated with hernias can be avoided if early detection, diagnosis and appropriate treatment is instituted in cases of umblical, paraumbilical, inguinal and femoral hernia. 10. Emergency surgery resulted in increased mortality. 11. To conclude, hernias in women are a significant health hazard. It affects the women of reproductive age group and leads to socio economic burden to the society if not treated promptly.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Anterior Abdominal Wall Hernia ; Women.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 05 Jun 2018 17:36
Last Modified: 06 Jun 2018 01:29

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