Computed tomography findings associated with the risk for emergency ventral hernia repair.

Abstract:

BACKGROUND:Conventional wisdom teaches that small hernia defects are more likely to incarcerate. We aim to identify radiographic features of ventral hernias associated with increased risk of bowel incarceration. METHODS:We assessed all patients who underwent emergent ventral hernia repair for bowel complications from 2009 to 2015. Cases were matched 1:3 with elective controls. Computed tomography scans were reviewed to determine hernia characteristics. Univariate and multivariable analyses were performed to identify variables associated with emergent surgery. RESULTS:The cohort consisted of 88 patients and 264 controls. On univariate analysis, older age, higher ASA score, elevated BMI, ascites, larger hernias, small angle, and taller hernias were associated with emergent surgery. On multivariable analysis, morbid obesity, ascites, smaller angle, and taller hernias were independently associated with emergent surgery. CONCLUSIONS:The teaching that large defects do not incarcerate is inaccurate; bowel compromise occurs with ventral hernias of all sizes. Instead, taller height and smaller angle are associated with the need for emergent repair. Early elective repair should be considered for patients with hernia features concerning for increased risk of bowel compromise.

journal_name

Am J Surg

authors

Mueck KM,Holihan JL,Mo J,Flores-Gonzales JR,Ko TC,Kao LS,Liang MK

doi

10.1016/j.amjsurg.2016.09.035

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

42-46

issue

1

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(16)30623-7

journal_volume

214

pub_type

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