Authors: Dossouvi Tamegnon, Kassegne Iroukora, Kanassoua Kokou Kouliwa, Dosseh Ekoué David.
Objectives: To determine the hospital frequency, identify the contributing factors and to analyze the management of abdominal incisional hernia at Kara teaching hospital (Togo).
Patients and Methods: This retro and prospective study spanned a period of 6 years from January 1, 2014 to December 31, 2019. It took place in the general and digestive surgery department of Kara teaching hospital (Togo).
Results: During our study period, we had treated 20 incisional hernia among the 4573 laparotomies performed. Among the patients, 10 were women and 10 were men. The mean age is 41 with the extremes ranging from 3 years to 65 years. The patients belonged to several socio-professional groups dominated by housewives and those in the liberal profession. The surgical history was dominated by laparotomies for peritonitis followed by hernias of the white line. The incisional hernia was in on the white line in 17 cases, on a Mouchel incision in 1 case, on a Mac Burney scar in one case and on a drain hole in the right flank in one case. Contributing factors were parietal infections in all cases of peritonitis and obesity in the three cases of white line hernia and in the case of exploratory laparotomy. Therapeutically, the incisional hernia was treated by sample raphy in 4 cases and by prosthesis in 16 cases. The implantation site of the prosthesis was pre-fascial retro muscular in 16 cases. The outcome was marked by an infection of the wall in one patient and a seroma in 1 prolonged case for about 15 days in 3 patients.
Conclusion: Abdominal incisional hernias are frequent but rare in our practice. They are a complication of abdominal surgery and recognize several contributing factors whom the most frequent are emergency surgery and obesity in our study. The lack of financial means in our poor countries hinders the generalization of the use of prostheses in the management of abdominal incisional hernia.View/Download pdf