Iberoamerican Journal of Medicine
Iberoamerican Journal of Medicine
Original article

Pattern of abdominal wall hernia in Shisong, Cameroon

Bamidele Johnson Alegbeleye

Downloads: 6
Views: 779


Introduction: There is the obscurity of published data on surgical management of external abdominal wall hernias in our environment. This study was, therefore, to describe the pattern, outcome, and experience in the surgical management of anterior abdominal wall hernias in Shisong, Cameroon.
Methods: This was a descriptive retrospective study conducted at St. Elizabeth Catholic General Hospital, Shisong. The various cases of abdominal wall hernias performed in the hospital during the study period of three years covering January 2017 to December 2019 by the surgical teams were included. We ensured that Ethical clearance and written informed consent were obtained before the start of the project. Information includes detailed sociodemographic data collected and analyzed by using SPSS 22 statistical software.
Results: 465 cases of various abdominal wall hernias were included in this study. The most common type of hernia was indirect inguinal hernia (86.5%), and one rare Spigelian hernia was also there. The sub-arachnoid block was the most prevalent form of anesthesia. The various surgical procedures performed, including herniotomy (8.7%), hernioplasty (38.7%), and herniorrhaphy (28.6%), which were done for various inguinal hernias. In contrast, only mesh repair (9%) was performed for epigastric, lumbar, umbilical, Spigelian, and incisional hernia. Amongst the inguinal hernias, 55.2% were right-sided, 40.6% were left-sided, and 4.2% were bilateral, whereas 50% each of femoral hernia was left and right-sided. Overall, the annual recurrence rate for groin hernia was 1.9%.
Conclusion: Inguinal Hernia was the most common type of hernia (86.3%). Among the inguinal hernia, the right side was more common (58.42%). The adoption of newer modalities of care should be considered standard. However, in resource-constrained settings like ours in Cameroon, the goal should be to perform a skillful and technically effective technique. Also, it is critical to ensure adequate anesthesia for optimal post-operative pain control, coupled with minimal morbidity.


Herniotomy; Hernioplasty; Inguinal hernia; Incisional hernia; Ventral hernia; Spigelian hernia


1. Igwe PO, Dodiyi-Manuel A, Nwankwo NU. Hernia in South Southern Nigeria: Five Year Retrospective Study. IOSR-JDMS. 2016;15(9):96-111. doi: 10.9790/0853-15090296111.
2. Ayandipo OO, Afuwape OO, Irabor DO, Abdurrazzaaq AI. Adult Abdominal Wall Hernia in Ibadan. Annal Ibad Pg Med. 2015;13(2):94-9.
3. Mabula JB, Chalya PL. Surgical management of inguinal hernias at Bugando medical centre in North-Western Tanzania: our experience in a resource-limited setting. BMC Research. 2012;5: 585. doi: 10.1186/1756-0500-5-585.
4. Primatesia P, Golacre MJ. Inguinal hernia repair, incidence of elective and emergency surgery. Int J Epidemiol. 1996;25:835-9. doi: 10.1093/ije/25.4.835.
5. El Rashied M, Widatalla AH, Ahmed ME. External strangulated hernia in Khartoum, Sudan. East Afr Med J. 2007;84:379-82. doi: 10.4314/eamj.v84i7.9545.
6. Mbah N. Morbidity and mortality associated with inguinal hernia in North-Western Nigeria. West Afr J Med. 2007;26(2):88-92. doi: 10.4314/wajm.v26i4.28329.
7. Naeder SB, Archampong EQ. Changing pattern of acute intestinal obstruction in Accra. West Afr J Med. 1993;12:82-8.
8. Anumar SA, Ismail T. Abdominal wall hernias in Upper Egypt: A different spectrum. East Cent Afr J Surg. 2008;13(2):109-13.
9. Javid PJ, Brooks D. Hernias. In: Zinner M.J and Ashley SW, Editors. Maingots Abdominal Operations vol. 1, 11th ed. New York: McGrawHill; 2007;103-09.
10. Garba ES. The pattern of adult external abdominal hernia in Zaria. Nig J Surg Res 2000;2(1):12-5. doi: 10.4314/njsr.v2i1.12176.
11. Sangwan M, Sangwan V, Garg M, Mahendirutta P, Garg U. Abdominal wall hernia in a rural population in India-is spectrum changing? Open J Epidemiol. 2013;3:135-8. doi: 10.4236/ojepi.2013.33020.
12. Nordberg EM. Incidence and estimated needs of caesarean section, inguinal hernia repair and operation for strangulated hernia in rural Africa. Br Med J. 1994;289:92-3. doi: 10.1136/bmj.289.6437.92.
13. Karatas T, Ozbag D, Kanlioz M. Retrospective analysis of inguinofemoral hernias. Medicine Science. 2020;9(1):86-9. doi: 10.5455/medscience.2019.08.9142.
14. Rutkow IM. A selective history of groin hernia surgery in the early 19th Century: The anatomic atlases of Astley Cooper, Franz Hesselbach, Antonio Scarpa, and Jules-Germain Cloquet. Surg Clin North Am. 1998;78:921-40. doi: 10.1016/S0039-6109(05)70362-5.
15. Pradeep G, Bishowdeep T. Pattern of Abdominal Wall Hernia attended in Fishtail Hospital, Pokhara, Nepal. J Chitwan Med Coll. 2018;8(24):32-6. doi: https://doi.org/10.3126/jcmc.v8i2.23735.
16. Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, et al.Schwartz’s principles of surgery. 10th ed. New York: McGraw-Hill; 2014.
17. Williams NS, O’Connel PR, McCaskie A. Bailey and Love’s Short practice of surgery 27th ed. CRC Press; 2018.
18. Schools IG, Van Dijkman B, Butzelaar RM, Van Geldere D, Simons MP. Inguinal hernia repair in Amsterdam region. Hernia. 2001;5(1):37-40. doi: 10.1007/bf01576163.
19. Kingsnorth AN, LeBlanc KA. Management of abdominal hernias. 3rd ed. New York: Edward Arnold; 2003.
20. Gulzar MR, Iqbal J, Ul haq MI, Afzal M. Darning versus Bassini repair for inguinal hernia; a prospective comparative study. Prof Med J. 2007;14(1):128-33.
21. Maggiore D, Muller G, Hafanki J. Bassini versus Lichtenstein: Two basic techniques for inguinal hernia repair. Hernia. 2001;5(1):21-4. doi: 10.1007/bf01576160.
22. Watkin D, Kirk R. Abdominal wall and groin. In: Kirk RM, editor. General Surgical Operations. 4th ed. New York: Churchill Living Stone; 2000:117-40.
23. Lal P, Kajla RK, Chander J, Saha R, Ramteke VK. Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc. 2003;17(6):850-6. doi: 10.1007/s00464-002-8575-6.
24. EU Hernia Trialists Collaboration. Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 2002;235(3):322-32. doi: 10.1097/00000658-200203000-00003.
25. EU Hernia Trialists Collaboration. Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg. 2000;87:854-9. doi: 10.1046/j.1365-2168.2000.01539.x.
26. Baloch M, Shaikh SM, Bhatti Y, Shaikh GS, Deenari RA. Moloney darn repair: versus Lichtenstein mesh repair: comparison of cost effectiveness & complications. Med Channel. 2010;16(1):81-3.
27. Rai S, Chandra SS, Smile SR. A study of the risk of strangulation and obstruction in groin hernias. Aust N Z J Surg. 1998;68:650-4. doi: 10.1111/j.1445-2197.1998.tb04837.x.
28. Ohene-Yeboah M. Strangulated external hernias in Kumasi. West Afr J Med. 2003;22:311-3. doi: 10.4314/wajm.v22i4.28053.
29. Jaenigen BM, Hopt UI, Obermaier R. Inguinal hernia mesh or no mesh in open repair? Zentralbl Chir. 2008;133:440-5. doi: 10.1055/s-2008-1076955.
30. Dodiyi-Manuel A, Wichendu PN. Inguinal Hernias in a Tertiary Hospital in South-South Nigeria. J Adv Med Med Res. 2018;25(9):1-6. doi: https://doi.org/10.9734/JAMMR/2018/38103.
31. Horharin P, Wilasrusmee C, Cherudchayaporn K, Pinyaku N, Phanpradi O, Phromsopha N.. Comparative study of tailor-made plug herniorraphy versus Lictenstein herniorraphy versus Bassini operation: a prospective clinical trial Asian J Surg. 2006;29(2):74-8. doi: 10.1016/S1015-9584(09)60111-1.
32. Cheek CM. Inguinal hernia repair: incidence of elective and emergency surgery. Int J Epidemiol. 1997;26(2):459-61. doi: 10.1093/ije/26.2.459.
33. Berliner SD. When is surgery necessary for groin hernias? Postgrad-Med. 1990;87:149-52. doi: 10.1080/00325481.1990.11704529.
34. Sanjay P, Woodward A. Inguinal hernia repair: local or general anaesthesia? Ann R Coll Surg Engl. 2007;89:497-503. doi: 10.1308/003588407X202056.
35. Menakuru SR, Phillip T, Ravindranath N, Fisher PW. Outcome of inguinal hernia repair at rural hospitals in northern Scotland. Surgeon. 2006;4:343-5. doi: 10.1016/s1479-666x(06)80109-5.
36. Gupta DK. Inguinal hernia in children: an Indian experience. Pediatr Surg Int. 1993;8:466-8.
37. Charles NR. A two year retrospective study of congenital inguinal hernia at western regional hospital, Nepal. J Nep Med Assoc. 2000; 39(133):172-5. doi: https://doi.org/10.31729/jnma.687.
38. Bendavid R, Abrahamson J, Arregui ME, Flament JB, Phillips EH. Abdominal wall hernias, principles and management.1st ed. New York: Springer verlag; 2001.
39. Osifo OD, Amusan TI. Outcome of giant inguinoscrotal hernia repair with lidocaine anaesthesia. Saudi Med J. 2010;31:53-8.
40. Álvarez JA, Baldonedo RF, Bear IG, Solis JAS, Alvares P, Jorge JI. Incarcerated groin hernias in adults: presentation and outcome. Hernia 2004;8:121-6. doi: 10.1007/s10029-003-0186-1.
41. Awojobi OA, Ayatunde AA. Inguinal hernia in Nigeria. Trop Doct. 2004;34:180-1. doi: 10.1177/004947550403400322.
42. Nathan JD, Pappas TN. Inguinal hernia: an old condition with new solution. Ann Surg. 2003; 238(6 Suppl):S148-57. doi: 10.1097/01.sla.0000097796.63010.e8.
43. Nesterenko IVA, Shovskii OL. Outcome of treatment of incarcerated hernia. Khirurgiia (Mosk). 1993;9:26-30.
44. Ashindoitiang JA, Ibrahim NA, Akinlolu OO. Risk factors for inguinal hernia in adult male Nigerian: A case control study. International Journal of Surgery 2012;10: 364-7. doi: doi: 10.1016/j.ijsu.2012.05.016.
45. Alegbeleye BJ. The Current Spectrum of Intestinal Obstruction at a Mission Hospital in Northwestern Cameroon. CPQ Medicine. 2019;5(5):1-14.
46. Ntakiyiruta G, Mukarugwiro B. Pattern of intestinal obstruction at Kibogola Hospital, a Rural Hospital in Rwanda. East Cent Afr J Surg. 2009;14(2):103-8.
47. McConkey SJ. Case series of acute abdominal surgery in rural Sierra Leone. World J Surg. 2002;26(4):509-13. doi: 10.1007/s00268-001-0258-2.
48. Otuu AA. Tropical surgical abdominal emergencies acute intestinal obstruction. Afr J Med Med Sci. 1991;20:83-8.
49. Sultan B, Qureshi Z, Malik MA. Frequency of external hernias in Ayub teaching hospital Abbottabad. J Ayub Med Coll Abbottabad. 2009;21(3):57-8.
50. Adesunkanmi AR, Faleyimu B. Incidence and aetiological factors of incisional hernia in post-caesarean operations in a Nigerian hospital. J Obstet Gynaecol. 2003;23(3): 258-60. doi: 10.1080/01443610306063.
51. Deveney KE. Hernias and other lesions of the abdominal wall. In: Way LW and Doherty GM, editors. Current surgical diagnosis and treatment, 11th ed. New-York: McGraw-Hill; 2003:783-96.
52. Ohene-Yeboah M, Abatanga FA. Inguinal Hernia Disease in Africa: a common but neglected surgical condition. West Afr J Med. 2011;30(2):77-83.
53. Olasehinde OO, Adisa AO, Agbakwuru EA, Etonyeaku AC, Kolawole OA, Mosonya AO. A 5 year review of Darning technique of inguinal hernia repair. Niger J Surg. 2015;21:52-5. doi: 10.4103/1117-6806.152722.
54. Thapar V, Rao P, Deshpande A, Sanghavi B, Supe AN. Shouldice’s herniorrhaphy versus Maloney’s darn herniorrhaphy in young patients (a prospective randomized study). J Postgrad Med. 2000;46(1):9-12.
55. Schutz C, BacaI, Götzen N. Laparoscopic inguinal hernia repair. Surg Endosc. 2001;15(6):582-4. doi: 10.1007/s004640000376.
56. McFarlane ME. Analgesia-sedation for day case inguinal hernia repair. A review of patient acceptance and morbidity. W Indian Med J. 2000;49:158-60.
57. Ajao OG. Obstructed groin hernia in a tropical African population. J Natl Med Assoc. 1979;71(11):1093-4.
58. Crawford DL, Phillips EH. Laparoscopic repair and groin hernia surgery. Surg Clin N Am 1998;78(6):1047-62. doi: 10.1016/S0039-6109(05)70368-6.
59. Kimyil VM, Iya D, Ogbonna BC, Dakum NK. Safety of daycare hernia repair in Jos, Nigeria. East Afr Med J 2000,77(6):326-8. doi: 10.4314/eamj.v77i6.46647.
60. Adesunkanmi AR, Badmus TA, Salako AA. Groin hernias in patients 50 years of age and above: pattern and outcome of management in 250 consecutive patients. West Afr J Med. 2000;19(2):142-7.

Submitted date:

Reviewed date:

Accepted date:

Publication date:

5e8c49be0e8825be220a5aca iberoamericanjm Articles
Links & Downloads

Iberoam J Med

Share this page
Page Sections