Page 45 - tmp

RESEARCH ARTICLE
Influence of Sonographic Imaging on Patients with Anterior

Abdominal Wall Hernias to Prevent Reoperations

5
4
3
2
1
Ali Enshaie , Saeed Kashefi , Vahideh Aghamohammadi , Seyfollah Rezaie , Niloofar Afshari , Khadijeh Nasiri 6
AbstrAct
Background: Hernia is defined as an area of weakness or complete disruption of the body wall’s fibromuscular tissues. Structures arising from the
cavity contained by the body wall can pass through, or herniate, through such a defect. The typical clinical finding is a bulged mass increasing in
size when intra-abdominal pressure rises. The hernia is asymptomatic or may cause severe pain for patients. Arising of intra-abdominal pressure
for each reason can generate anterior abdominal wall hernias; on the contrary, each synchronous surgically treatable intra-abdominal disease
can be revealed with the same symptoms, and distinction of this disease prior to the surgery is important.
Materials and methods: This study was conducted on 90 patients who were candidates for anterior abdominal wall herniorrhaphy. All patients
were screened for the coexistence of intra-abdominal surgically treatable diseases using the abdominopelvic sonographic examination. According
to our project, patients with a synchronous intra-abdominal illness were treated with single surgery for their hernia and surgically treatable
disease. Other patients with the healthy sonographic report were only subject to herniorrhaphy.
Results: The sonographic report was normal in 53 patients and abnormal (including cholelithiasis or any synchronous surgically treatable
disease) in 37 patients. The study of the population using the Chi-square test to determine the need for further surgery (normal sonographic
report rate) showed a statistical difference between hernia groups (p = 0.001). In the umbilical hernia group, the need for further surgery is
significantly lower than that in the other groups (p <0.001).
Conclusions: The coexistence of intra-abdominal surgically treatable disease with anterior abdominal wall hernias and their possible recurrence
due to the remaining of the intra-abdominal illness as a source for intra-abdominal cavity pressure convinced surgeons to carefully check
patients for each surgically treatable intra-abdominal disease before surgery.
Keywords: Abdominal wall hernia, Cholelithiasis, Sonography.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1445

IntroductIon 1,2,4 Department of General Surgery, School of Medicine, Urmia
Anterior abdominal wall hernias are described as the weakness University of Medical Sciences, Urmia, Iran
in the fibromuscular layer of the abdominal wall, which can be 3 Department of Nutrition, Khalkhal University of Medical Sciences,
congenital or acquired. Based on their arising anatomic region, Khalkhal, Iran
hernias are divided into umbilical, epigastric, primary ventral, 5 Department of Dermatology, School of Medicine, Tabriz University of
secondary ventral (incisional), and Spigelian subtypes. An umbilical Medical Sciences, Tabriz, Iran
hernia is the most common type of hernia and is generally prevalent 6 Department of Nursing, Khalkhal University of Medical Sciences,
in premature newborns. The incidence of umbilical hernia in the Khalkhal, Iran
adult is mostly unknown, but most cases are thought to be acquired Corresponding Author: Saeed Kashefi, Department of General Surgery,
rather than congenital. It is known to occur more commonly in adult School of Medicine, Urmia University of Medical Sciences, Urmia,
females (with a 3:1 ratio). An umbilical hernia is more commonly Iran, Phone: +984431988000, +989143478332, e-mail: s.kashefi.s
found in association with processes that increase intra-abdominal 1986@gmail.com
1
pressure. Almost all surgeons prefer conservative treatment for How to cite this article: Enshaie A, Kashefi S, Aghamohammadi V,
2
umbilical hernia in children up to 5 years old. Epigastric hernias et al. Influence of Sonographic Imaging on Patients with Anterior
occurring between umbilicus and xiphoid processes are prevalently Abdominal Wall Hernias to Prevent Reoperations. World J Lap Surg
1
detected in older adults versus women with a 3:1 ratio. Secondary 2021;14(2):111–113.
ventral hernias prevalently occur after abdominal incisions, and Source of support: Nil

small incisions can prevent such hernias. Risk factors for these Conflict of interest: None
hernias include increasing age, malnutrition, ascites, diabetes,
obesity, smoking, long-term corticosteroid consumption, sepsis
after surgery, wound infections, and emergency surgeries.
Spigelian hernia is present near the arcuate line exactly lateral lateral of the abdomen, namely medial to oblique and lateral to the
to rectus abdominis muscle. The diagnosis of Spigelian hernia lateral border of rectus abdominis muscle, respectively. In terms
3
is associated with challenges because of its complex regional of size, they are small (<2 cm), midsize (2–4 cm), or large (>4 cm).
1
anatomy. European Hernia Association has presented a general Diagnosis of all hernia types is made clinically, and they can be
1
classification of primary anterior abdominal wall hernias, the treated by laparoscopic or classic methods. Another aspect of
consideration of which is helpful to conduct the study. Based on this study was related to synchronous intra-abdominal surgically
this classification, anterior abdominal hernias are at midline or treatable diseases, the most prevalent of which is cholelithiasis.
© Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons
Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.