European Journal of Molecular & Clinical Medicine

A rare consequence of incisional hernia is spontaneous rupture. There isn't much literature to support it. A postponement of surgery can result in gangrene of the bowel and further morbidity. Mesh repair versus anatomical repair is still up for dispute. We are presenting a malnourished patient who had eviscerated bowel for 10 hours following an episode of vomiting. As a result of prompt therapy, we were able to avoid resection anastomoses, mesh was not indicated, and postoperative outcomes were excellent with no cough impulse

BACKGROUND: Incisional hernia is the hernia that presents at the site of a previous incision. It is one true iatrogenic hernia. Study of its clinical presentation and management may help its prevention. This study was performed to review clinical profile and management of incisional hernia in our institute.
METHODS: This study was conducted in the Department of General Surgery at KIMSDU, Karad. 60 patients underwent surgery for incisional hernia. Data on clinical presentation, type of operative procedure, and post-operative complications were collected.
RESULTS: 60 cases underwent surgery for an incisional hernia, female predominance, and age group of 35-45 years and 56-65 were common, about 9(15%) of patients had pre-operative pain,  the most common previous surgery was LSCS 23(38.33%), the most common surgical incision was Pfannenstiel 27(45%), more common in the infraumbilical region (83.33%), 7(11.67%) had post op SSI, major comorbidity was obesity, most common operative management was sublay (preperitoneal) meshplasty.
CONCLUSION: Incisional hernia is more common in females.. In our study most of the incisional hernia occurred in infraumbilical incisions. Patients with comorbidities such as obesity, diabetes mellitus, COPD had higher chances of hernia occurrence.

Aim: The aim of this study to determine the complications and causes of incisional hernia repair with preperitoneal meshplasty.
Material and methods: Fifty patients hospitalised with the diagnosis of incisional hernia to various surgical wards underwent open preperitoneal polypropylene mesh surgery. Six months to one year after surgery, it was reviewed for problems and recurrence, and the findings were recorded. Incisional hernia patients were included in this research if they were between the ages of 14 and 77.
Results: There were 40 female patients and 10 male patients among the 50 total. In terms of defect size, 12 patients had less than 2 cm, 34 patients had between 2.1-4 cm, 2 patients had between 4.1-6 cm, and 2 patients had between 6.1-8 cm. Infraumbilical hernia was found in 39 cases, whereas supraumbilical hernia was found in 11 patients. In terms of post-operative complications, four patients experienced seroma, two had edge necrosis, two had post-op ileus, and two had persistent discomfort. Six patients were followed for six months, twelve for nine months, and thirty-two for a year.
Conclusion: The current research found that open preperitoneal polypropylene mesh repair has much less postoperative problems compared to other mesh repair procedures, and that there was no recurrence among its individuals throughout the follow-up period.

Background: The aim of this study is to compare conventional cholecystectomy and
laparoscopic cholecystectomy.
Materials and Methods: The study subjects consisted of 40 patients with a diagnosis of
calculous cholecystitis that underwent cholecystectomy at Bhaskar Medical College and
General Hospital, yenkapally from January 2018 to June 2019. The patients will be
evaluated for detailed clinical history according to a definite proforma. All the patients
will be examined and routine blood investigations with LFT wherever necessary will be
done. Abdominal USG will be performed in all the cases.
Results: The commonest presenting complaint in both the groups was pain in the right
upper quadrant followed by vomiting, fever and dyspepsia. Majority of the patients in
both the groups had multiple stones. (15 patients in LC group and 14 patients in OC
group) The duration of LC was significantly more than for OC (median 105 min v/s
75min respectively). The intra operative blood loss and the complications were more for
the open procedure. Two patients of laparoscopic group required conversion to open
procedure. The drains were required in less number of patients of LC group and for
less number of days. Wound infection was seen in 1 of LC patient and 5 of OC patients.
One patient of OC group developed incisional hernia. The antibiotic requirement was
less in LC group (median 5days) compared to OC group (median 7days). The Visual
Analogue Scale for pain in the post op period was significantly less for LC patients
compared to OC patients (median Grade1 v/s Grade3 respectively). The duration of
pain in the LC group was significantly less (median of 2 days) compared to OC group
(median of 4 days). The analgesic requirement was significantly less in LC patients
(median for3days) compared to OC patients (median for 5 days). The LC patients
tolerated oral feeds earlier compared to OC patients (6- 8hours compared to 12-36
hours respectively). The duration of hospital stay was significantly longer for OC group
than for LC group (median 7 days versus 4 days respectively). The time to return to
normal work was delayed for OC group (median 8 days) compared to LC group
(median 5 days). The cosmetic end result was unacceptable in majority of OC patients
(14 of 20). While majority of LC patients were satisfied with the operative scar (16 of
20).
Conclusion: The laparoscopic procedure was costly compared to open procedure. But
this difference was overcome by the other costs incurred in post-operative period of
open procedure.

Background:The present study is a Clinical Profile and Management of Incisional
Hernia in a Rural Tertiary Care Hospital done at Kamineni Institute of Medical
Sciences, Narketpally, from October 2015 to September 2017.
Materials and Methods: Forty cases of incisional hernia which were admitted in
Kamineni Institute of Medical Sciences were studied. The statistical data and analysis of
the cases studied during this period are presented in this study.
Results: It is more common in females than in males with a ratio of 4.71:1. Incidence of
incisional hernia was highest in the age group ranging from 40- 60 years. Most of the
patients presented with swelling (82.5%) and swelling with pain (12.5%). Incisional
hernia was more common in patients with previous history of gynecological operations
(52.5%). The incisional hernia was more common in the infra-umbilical region (52.5%).
In majority of patients (95%) the incisional hernia occurred within 3 years of previous
operation. The size of the hernial defect less than 40sq.cms was found in 22 patients
(55%).33 patients (70%) underwent mesh repair (30 Onlay and 3 sublay repairs), which
had good outcome and minimal post operative complications whwn compared to
anatomical repair. Post-operative complications included wound infection in 5 patients
(12.5%) followed by seroma in 3 patients (7.5%) and no complications in 31 patients.
There was only one recurrence constituting for 2.5% of total forty cases reported, and
there was zero mortality in the study.
Conclusion: Wound infection following previous surgery was the most important risk
factor associated with incisional hernia. The other risk factors were obesity and COPD.
Polypropylene mesh repair is superior to anatomical repair as it has less recurrence.

Background: The risk factors for the development of incisional hernia include obesity,
diabetes, emergency surgery, postoperative wound dehiscence, smoking and
postoperative wound infection. The present study was conducted to compare different
treatment modalities of management of incisional hernia.
Materials & Methods: 80 patients of incisional hernia of both genders. The consent was
obtained from all enrolled patients.
Data such as name, age, gender etc. was recorded. Routine investigations such as CBC,
bleeding time, clotting time etc. was done. Patients were divided into 2 groups. Group I
was treated with inlay and group II were treated with sublay technique.
Results: Group I comprised of 28 males and 12 females and group II had 16 males and
24 females. Common complication reported was seroma formation 3 in group I and 1 in
group II, wound dehiscence 2 in group I and recurrence 2 in group I and 1 in group II.
Risk factors was diabetes was seen in 7 and 5 in group II, obesity was seen in 4 in group
I and 2 in group II and smoking was seen in 10 in group I and 13 in group II.
Conclusion: Both techniques were comparable in terms of risk factors and
complications.