Nigerian Journal of Surgical Sciences

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 28  |  Issue : 2  |  Page : 26--33

Delay in presentation and challenges of treatment of complicated abdominal wall hernias in rural Southeast Nigeria


Aloysius Ugwu-Olisa Ogbuanya1, David Amah2 
1 Department of Surgery, Bishop Shanahan Specialist Hospital, Nsukka; Department of Surgery, Mater Misericordie Hospital, Afikpo; Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abalaliki; Department of Surgery, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
2 Department of Surgery, Mater Misericordie Hospital, Afikpo, Nigeria

Correspondence Address:
Dr. Aloysius Ugwu-Olisa Ogbuanya
Bishop Shanahan Specialist Hospital, Nsukka, Enugu State; Mater Misericordie Hospital, Afikpo, Ebonyi State; Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abalaliki, Ebonyi State; Department of Surgery, Ebonyi State University, Abakaliki, Ebonyi State
Nigeria

Background: Delay in presentation and treatment of abdominal wall hernias is phenomenal in Africa. The three-pronged problem of delayed presentation, multiple comorbidities, and advancing age makes management of complicated abdominal wall hernias more tasking and hazardous. The purpose of this study was to determine the causes of delayed presentation and treatment outcomes of complicated abdominal wall hernias in our environment. Patients and Methods: This was a 3-year multicenter prospective study of the causes of delayed presentation and treatment outcomes of complicated abdominal wall hernias in rural Southeast Nigeria. Results: A total of 138 patients with complicated abdominal wall hernias were enrolled and comprised of 117 males and 21 females. Of the entire patients, those with inguinal hernia represented 76.1% followed by umbilical hernia (8.0%). Only 18.1% presented within 24 h after the onset of complications, 24.6% between 24 and 48 h, 29.0% between 49 and 72 h, and 28.3% after 72 h. In the preoperative period, theater waiting time was 0–12 h in 10.9%, 13–24 h in 23.2%, 25–48 h in 39.1%, and >48 h in 18.1%. The major barriers against early presentation were financial constraint (23.9%) and treatment at alternative homes (15.9%). The overall morbidity rate was 58.0%, whereas the mortality rate was 13.8%. The bowel resection rate was 26.1%, and majority of the resection (77.8%) and deaths (73.7%) occurred in those who had overall delay beyond 72 h before surgical repair. Conclusion: The rates of morbidity and mortality were proportionally related to the length of delay in the presentation and duration of waiting time before operative repair.


How to cite this article:
Ogbuanya AU, Amah D. Delay in presentation and challenges of treatment of complicated abdominal wall hernias in rural Southeast Nigeria.Niger J Surg Sci 2018;28:26-33


How to cite this URL:
Ogbuanya AU, Amah D. Delay in presentation and challenges of treatment of complicated abdominal wall hernias in rural Southeast Nigeria. Niger J Surg Sci [serial online] 2018 [cited 2021 Feb 28 ];28:26-33
Available from: https://www.njssjournal.org/article.asp?issn=1116-5898;year=2018;volume=28;issue=2;spage=26;epage=33;aulast=Ogbuanya;type=0