Management of Strangulated Groin Hernias in Adults at the Brazzaville University Hospital

Purpose: To report our experience in the management of strangulated groin hernias in adults.

Patients and Method: This was a descriptive, retrospective study conducted in the medical-surgical emergency department of the Brazzaville University Hospital Centre over a 36-month period (1er January 2020 to 31 December 2022).

Results: During the study period, 1,715 patients underwent surgery in the emergency department, including 113 cases of strangulated groin hernia (frequency: 6.58%). The mean age of our patients was 45.62 ± 17.26 years, with extremes of 18 and 90 years. Males predominated, with 109 cases (96.46%). The hernia was inguinal in 39.93% of cases (44 patients), inguinal-scrotal in 59.29% (67 patients) and crural in 1.76% (2 cases). It was located on the right in 75% of cases and on the left in 25%. The average consultation time for our patients was 37.88 ± 32.31 hours, with extremes ranging from 4 to 120 hours. Most of the contents of the pouch were small intestines and 105 patients had viable intestines. The most frequently performed hernia repair was the McVay repair in 80.53% of cases, i.e. 91 patients, followed by the Bassini repair in 18.58% of cases, i.e. 21 patients. One patient had a prosthetic cure (0.88%). The associated procedures were: resection with small bowel anastomosis in 6 patients (5.31%) and ileostomy in 02 patients (1.77%). Post-operative management was straightforward in 104 patients (92.03%) and complicated by parietal suppuration in 8 patients (7.08%).

Conclusion: Hernial strangulation of the groin remains a frequent pathology in our context. Its treatment is a genuine surgical emergency. Cure by raffia is still the treatment of choice in our context.

Keywords: Groin Hernia, Strangulation, Adult, Brazzaville.