Coexisting Inguinal and Umbilical Hernias as a Clinical Indicator of Diffuse Abdominal Wall Deficiency: A Case Study |Chapter 13 | Medical Science: Updates and Prospects Vol. 4

 

The lifetime risk profile for inguinal hernia is characterised by a profound sexual dimorphism, with males facing an approximate 27% cumulative incidence, ninefold greater than the 3% risk observed in females. This condition exhibits a marked predilection for the elderly, where its incidence peaks at roughly 13 cases per 1,000 individuals. Notably, the global epidemiological burden of inguinal hernia has escalated significantly, demonstrating a 36% surge in occurrence over the preceding three decades. In the spectrum of anterior abdominal wall defects, umbilical hernias rank as the third most prevalent, manifesting in an estimated 5% to 12% of the adult population. Against this clinical backdrop, this case report investigates the procedural viability and outcomes of a single-stage surgical strategy for the concomitant management of inguinal and umbilical hernias. We present a 62-year-old male patient with a 12-month history of a symptomatic, reducible right indirect inguinal hernia (4x2x2 cm) and an incidental, reducible umbilical hernia (3x3x2 cm) with exertion-triggered pain. The patient had no significant comorbidities or history of incarceration. He successfully underwent a unified operative session under spinal anaesthesia, comprising a standard Lichtenstein hernioplasty for the inguinal defect and a modified Mayo repair augmented with polypropylene mesh for the umbilical hernia. The total procedural duration was recorded at 80 minutes. The postoperative convalescence was uncomplicated, facilitating discharge on the sixth day. Critically, at the 36-month long-term follow-up, the patient reported complete resolution of symptoms and exhibited an excellent clinical outcome. There was no radiological or clinical evidence of recurrence at either surgical site, nor were there any sequelae of chronic groin pain, mesh-related complications, or surgical site infection. This successful outcome substantiates the proposition that a single-stage, mesh-reinforced repair under spinal anaesthesia constitutes a clinically feasible and resource-optimised therapeutic pathway. The approach offers distinct advantages by consolidating the surgical intervention into a solitary anaesthetic episode and a unified recovery period, thereby enhancing patient convenience and potentially reducing systemic healthcare costs. Nevertheless, while these preliminary results are highly encouraging, they necessitate rigorous corroboration through prospective, randomised controlled trials with larger cohorts. Such studies are imperative to definitively establish this integrated approach as a superior and standard-of-care alternative to traditional staged repairs for suitable patient candidates.

 

 

Author(s) Details

Mekhaeel, Shehata Fakhry Mekhaeel
Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University) Medical Institute, Department of Operative Surgery and Clinical Anatomy named after I.D. Kirpatovsky, Moscow, Russia.

 

Salem, Mohamed Ahmed Eissa Sameh
Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University) Medical Institute, Department of Operative Surgery and Clinical Anatomy named after I.D. Kirpatovsky, Moscow, Russia.

 

Elshliby, Abdelrahman Gomaa Zaky Ali
Kirov State Medical University, Kirov, Russia.

 

Ali, Omar Mohamed Ismail Mahmoud
Kirov State Medical University, Kirov, Russia.

 

Ba Madhag, Abdulrahman Khaled Mubarak Al-Naggar
Kirov State Medical University, Kirov, Russia.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v4/6951