Assessment of diagnostic criteria of incarcerated inguinal hernia

An appropriate approach to surgical patients in emergency situations needs meticulous consideration, especially those with incarcerated inguinal hernias, since delay or inappropriate treatment may lead to severe complications or even death. According to this fact, medical records of patients with incarcerated inguinal hernias referred to emergency department of Sina hospital were surveyed during a 40 year period by a retrospective study. Routine criteria indicating strangulation in incarcerated inguinal hernia were compared between a group of patients with intestinal necrosis and those without this complication. Among 87 patients with relatively complete records which were all operated (immediately or with some delay), 13 patients had intestinal necrosis for whom intestinal resection was performed. The comparison between the gangrenous group and those without grangrene according to the mean interval between the onset of symptoms and hospitalization, body temperature, pulse rate and WBC count, was performed by student t-test, but no significant difference was found. Considering the safety of surgery especially for anterior herniorrhaphy which ia familiar to all surgery residents, the authors suggest immediate operation through ant. approach for incarcerated inguinal hernias