Management of Giant Inguinoscrotal Hernia in Resource Limiting SettingRoger Lebeau*, Kouakou Ibrahim Anzoua, Mamadou Traoré, Ismael Leh BI Kalou, Ahou Bernadette N’Dri, Aka Gérard Kakou and Bamourou Diané
General and Digestive Surgery Department, Bouaké Teaching Hospital, Cote D'ivoire
- *Corresponding Author:
- Dr.Roger Lebeau
Medical Doctor, General and Digestive Surgery Department
Bouaké Teaching Hospital, 01 P.O. box 376 Bouaké 01, CoteD'ivoire
Tel: (00225) 49764588
E-mail: [email protected]
Received date: November 15, 2015, Accepted date: December 22, 2015, Published date: January 02, 2016
Citation: Lebeau R, Anzoua KI, Traoré M, Kalou ILBI, N’Dri AB, et al. (2016) Management of Giant Inguinoscrotal Hernia in Resource Limiting Setting. J Gastrointest Dig Syst 6:376. doi:10.4172/2161-069X.1000376
Copyright: © 2016 Lebeau R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purposes: To describe our experience in the management of giant inguino-scrotal hernia outlining the epidemiological, clinical profil, treatment and outcome after treatment. Methods: A Descriptive and retrospective study was carried out of giant inguino-scrotal hernia seen between 2007 and 2014 at Bouaké teaching hospital in the central part of our country (Côte d’Ivoire) and during free rural medical missions for hernia treatment organized by a non governemental organization. A structured questionnaire was designed including for each patient, socio-demographic data, clinical profil, treatment and outcome after treatment. Results: During the period under study 30 patients with giant inguino-scrotal hernia were taking in charge. The ages of our patients ranged from 15 to 60 years with a mean age of 48.5 years. The duration of symptoms ranged 5 to 25 years with a mean of 10.2 years. Reasons for late presentation were mainly financial constraints (n=11). Hernia was irreducible in four patients. A pre-operative progressive pneumoperitoneum was conducted in those four patients. During operation reduction of the hernia content into the abdominal cavity was impossible in one patient. In this patient a debulking left hemicolectomy with colo-rectal anastomosis was necessary. Hernia repair was conducted in all patients, with Lichtenstein procedure (n=10), Shouldice procedure (n=7) Bassini’s procedure (n=7), Mc Vay’s procedure (n=4) and Stoppa’s procedure (n=2). Abdominal compartment syndrome (ACS) occurred per operatively in three patients. Two of them underwent emergency midline laparotomy followed by an exclusive skin closure and the third patient died on the operating table. In post-operative period scrotal hematoma was found in 12 patients (41.4%), suppuration of the inguinal wound in 3 patients and scrotal seroma in 2 patients. The average length of hospital stay was 4.75 days (3 days to 9 days) and after a mean follow up period of 29.19 months (range 7 months to 53 months), no recurrence was observed.