Strangulated Hernia, a Persisting Surgical Emergency: Epidemiology and Management at Tengandogo University Hospital (Burkina Faso)
Keywords:
Strangulated hernia, Surgical emergency, Hernia repair, Mesh, Sub-Saharan Africa
Abstract
Introduction: Strangulated hernia is a frequent and potentially serious surgical emergency that can be life-threatening. The objective of the study was to investigate the epidemiological, diagnostic, therapeutic and outcome aspects of patients managed for strangulated hernias.
Materials and methods: This was a retrospective observational study with a descriptive and analytical purpose, conducted over a 10-year period from January 1, 2016 to December 31, 2025 at Tengandogo University Hospital.
Results: We collected 102 cases of strangulated hernia, accounting for 5% of surgically managed abdominal emergencies. The mean age of patients was 44 years, with a male predominance (sex ratio = 2.18). Manual laborers represented 44.1% of occupations. Clinically, all patients presented with a painful, irreducible swelling that was non-impulsive and non-expansive on coughing. Inguino-scrotal hernias were found in 43.1% of cases. Mesh repair was performed in 35.3% of patients. The small intestine was incarcerated in 46.1% of cases. The postoperative course was complicated in 7.8% of cases. Residual pain was reported in 14.7% of cases and recurrence was noted in 6.8% of cases. The Bassini technique was associated with residual pain (p = 0.0387), while the Mac Vay technique was associated with recurrence (p = 0.0496) ); however, this result should be interpreted with caution given the very small number of patients in this subgroup (n = 4).
Conclusion: Reducing consultation delays and improving access to elective surgery are major challenges to limit these complicated forms. When they occur, mesh repair can be considered and is effective in the absence of any contraindication.
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References
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22. Ohene-Yeboah, M., & Dally, C. K. (2014). Strangulated inguinal hernia in adult males in Kumasi. Ghana Medical Journal, 48(2), 101–105. https://doi.org/10.4314/gmj.v48i2.8
23. Pavithira, G., Dutta, S., Sundaramurthi, S., & Nelamangala Ramakrishnaiah, V. P. (2022). Outcomes of emergency abdominal wall hernia repair: experience over a decade. Cureus, 14(6), e26324. https://doi.org/10.7759/cureus.26324
24. Piltcher-da-Silva, R., Sasaki, V. L., Bettini, L. F. C., Soares, P. S. M., Valandro, I. G., & Cavazzola, L. T. (2023). Outcomes of emergency groin hernia repair in the elderly: a systematic review. Journal of Abdominal Wall Surgery, 2, 11246. https://doi.org/10.3389/jaws.2023.11246
25. Sawadogo, Y. E. (2024). Les hernies pariétales étranglées au Centre Hospitalier Universitaire Yalgado Ouédraogo. Journal de Chirurgie et Spécialités du Mali, 4(2), 35–44.
2. Attolou, S., Bilubi, J.-J. P., Laleye, M., Hounsou, N., Fadonougbo, P., Atchou, B., Chabi-Yorouba, M., Lissanon, T., Gbessi, D., & Dossou, F. (2026). Surgical abdominal wall pathologies in adults: epidemiological, diagnostic and therapeutic aspects at the Suru-Lere University Teaching Hospital (CHUZ-SL), Cotonou, from 1 January 2022 to 31 December 2024. SAS Journal of Surgery, 12(01), 81–87. https://doi.org/10.36347/sasjs.2026.v12i01.014
3. Birindelli, A., Sartelli, M., Di Saverio, S., Coccolini, F., Ansaloni, L., van Ramshorst, G. H., Campanelli, G., Khokha, V., Moore, E. E., Peitzman, A., Velmahos, G., Moore, F. A., Leppaniemi, A., Burlew, C. C., Biffl, W. L., Koike, K., Kluger, Y., Fraga, G. P., Ordonez, C. A., … Catena, F. (2017). 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias. World Journal of Emergency Surgery, 12(1), 37. https://doi.org/10.1186/s13017-017-0149-y
4. Bittner, R., Arregui, M. E., Bisgaard, T., Dudai, M., Ferzli, G. S., Fitzgibbons, R. J., Fortelny, R. H., Klinge, U., Kockerling, F., Kuhry, E., Kukleta, J., Lomanto, D., Misra, M. C., Montgomery, A., Morales-Conde, S., Reinpold, W., Rosenberg, J., Sauerland, S., Schug-Pass, C., … Chowbey, P. (2011). Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surgical Endoscopy, 25(9), 2773–2843. https://doi.org/10.1007/s00464-011-1799-6
5. Ekwesianya, A. C., Ayantunde, A., & Nour, H. M. (2024). Assessing the safety of mesh repair in strangulated groin hernias: a systematic review and meta-analysis. Cureus, 16(9), e70496. https://doi.org/10.7759/cureus.70496
6. Gao, J., Xu, M., Chen, J., Zheng, Y., & Huang, X. (2026). Mesh safety under contamination across incarcerated hernias: a single-center cohort analysis with a systematic review of adult Bochdalek hernia complicated by gastric pathologies. The American Surgeon, 00031348251409256. https://doi.org/10.1177/00031348251409256
7. HerniaSurge Group. (2018). International guidelines for groin hernia management. Hernia: The Journal of Hernias and Abdominal Wall Surgery, 22(1), 1–165. https://doi.org/10.1007/s10029-017-1668-x
8. Isenberg, E. E., Fry, B. T., Sinamo, J., Howard, R. A., Ehlers, A. P., Shao, J. M., Jean, R. A., & Telem, D. A. (2025). Long-term recurrence and the safety of mesh use after emergency ventral hernia repair. JAMA Network Open, 8(11), e2544303. https://doi.org/10.1001/jamanetworkopen.2025.44303
9. Joe, C., Gowda, V., & Koganti, S. (2019). Laparoscopic assisted repair of strangulated obturator hernia—way to go. International Journal of Surgery Case Reports, 61, 246–249. https://doi.org/10.1016/j.ijscr.2019.07.029
10. Johnson, P. L., Mullens, C. L., Jean, R. A., Lindsey, H. J., Dimick, J. B., & Hemmila, M. R. (2025). Emergency hernia repair outcomes for patients with and without established hernia care with a surgeon. JAMA Network Open, 8(9), e2531290. https://doi.org/10.1001/jamanetworkopen.2025.31290
11. Kallinowski, F., Fortelny, R. H., Köckerling, F., Mayer, F., Morales-Conde, S., & Sandblom, G. (2022). Editorial: Mesh complications in hernia surgery. Frontiers in Surgery, 9, 841672. https://doi.org/10.3389/fsurg.2022.841672
12. Khamajeet, A., Diab, A., Marchant, S., & Bougard, H. (2025). An adapted hybrid of open and laparoscopic techniques for ventral hernia repair in a resource-constrained setting. Cureus, 17(3), e81095. https://doi.org/10.7759/cureus.81095
13. Köckerling, F., Hoffmann, H., Mayer, F., Zarras, K., Reinpold, W., Fortelny, R., Weyhe, D., Lammers, B., Adolf, D., & Schug-Pass, C. (2021). What are the trends in incisional hernia repair? Real-world data over 10 years from the Herniamed registry. Hernia: The Journal of Hernias and Abdominal Wall Surgery, 25(2), 255–265. https://doi.org/10.1007/s10029-020-02319-y
14. Lai, S. D., Smith, N. J., Park, B., Vandal, A., & MacCormick, A. D. (2025). Laparoscopic versus open approach for emergency repair of groin hernias: a systematic review and meta-analysis. World Journal of Surgery, 49(10), 2733–2741. https://doi.org/10.1002/wjs.70076
15. Lebeau, R., Traoré, M., Anzoua, K. I., Kalou, I. L. B., N'Dri, A. B., Aguia, B., Kakou, A. G., & Diané, B. (2016). Prognostic factors of postoperative morbidity and mortality of adult strangulated groin hernia. The Indian Journal of Surgery, 78(3), 192–196. https://doi.org/10.1007/s12262-015-1343-3
16. Magagi, I. A., Adamou, H., Habou, O., Magagi, A., Halidou, M., & Ganiou, K. (2017). Digestive surgical emergencies in Sub-Saharan Africa: a prospective study of a series of 622 patients at the National Hospital of Zinder, Niger. Bulletin de la Société de Pathologie Exotique, 110(3), 191–197. https://doi.org/10.1007/s13149-016-0499-9
17. Meara, J. G., & Greenberg, S. L. M. (2015). The Lancet Commission on Global Surgery Global Surgery 2030: evidence and solutions for achieving health, welfare and economic development. Surgery, 157(5), 834–835. https://doi.org/10.1016/j.surg.2015.02.009
18. Meara, J. G., Leather, A. J. M., Hagander, L., Alkire, B. C., Alonso, N., Ameh, E. A., Bickler, S. W., Conteh, L., Dare, A. J., Davies, J., Mérisier, E. D., El-Halabi, S., Farmer, P. E., Gawande, A., Gillies, R., Greenberg, S. L. M., Grimes, C. E., Gruen, R. L., Ismail, E. A., … Yip, W. (2015). Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet, 386(9993), 569–624. https://doi.org/10.1016/S0140-6736(15)60160-X
19. Melkemichel, M., Holmberg, H., Dahlstrand, U., & de la Croix, H. (2025). Short- and long-term outcomes after emergency groin hernia surgery: a nationwide population-based study from the Swedish Hernia Register. Journal of Clinical Medicine, 14(7), 2397. https://doi.org/10.3390/jcm14072397
20. Ndong, A., Diallo, A. C., Falola, A. F., Ndiaye, M. A., Faye, M., Faye, P. M., Niasse, A., Fall, S. M. A., Cissé, M., & Konaté, I. (2025). Knowledge and practices regarding chronic pain after groin hernia surgery: a national resident survey in Senegal. Journal of Abdominal Wall Surgery, 4, 13764. https://doi.org/10.3389/jaws.2025.13764
21. Ndong, A., Togtoga, L., Bah, M. S., Ndoye, P. D., & Niang, K. (2024). Prevalence and mortality rate of abdominal surgical emergencies in Sub-Saharan Africa: a systematic review and meta-analysis. BMC Surgery, 24(1), 35. https://doi.org/10.1186/s12893-024-02319-0
22. Ohene-Yeboah, M., & Dally, C. K. (2014). Strangulated inguinal hernia in adult males in Kumasi. Ghana Medical Journal, 48(2), 101–105. https://doi.org/10.4314/gmj.v48i2.8
23. Pavithira, G., Dutta, S., Sundaramurthi, S., & Nelamangala Ramakrishnaiah, V. P. (2022). Outcomes of emergency abdominal wall hernia repair: experience over a decade. Cureus, 14(6), e26324. https://doi.org/10.7759/cureus.26324
24. Piltcher-da-Silva, R., Sasaki, V. L., Bettini, L. F. C., Soares, P. S. M., Valandro, I. G., & Cavazzola, L. T. (2023). Outcomes of emergency groin hernia repair in the elderly: a systematic review. Journal of Abdominal Wall Surgery, 2, 11246. https://doi.org/10.3389/jaws.2023.11246
25. Sawadogo, Y. E. (2024). Les hernies pariétales étranglées au Centre Hospitalier Universitaire Yalgado Ouédraogo. Journal de Chirurgie et Spécialités du Mali, 4(2), 35–44.
Published
2026-06-10
How to Cite
Doamba, R. N., Windsouri, M., Sade, J. F. N., Rabo, F., Traore, B. T. L., Zebango, A., Sanon, A. F., Yaro, I. I., Zigani, S. S. C., Kabore, R. A. F., & Sanou, A. (2026). Strangulated Hernia, a Persisting Surgical Emergency: Epidemiology and Management at Tengandogo University Hospital (Burkina Faso). European Scientific Journal, ESJ, 54, 195. Retrieved from https://eujournal.org/index.php/esj/article/view/21134
Section
ESI Preprints
Copyright (c) 2026 Rodrigue Namekinsba Doamba, Mamadou Windsouri, Jean Flores N‘doubare Sade, Faizah Rabo, Bazin Thony Lionel Traore, Adama Zebango, Aimee Florence Sanon, Ignace Imbe Yaro, Soukoula Stephane Corentin Zigani, Raweleguinbasba Armel Flavien Kabore, Adama Sanou
This work is licensed under a Creative Commons Attribution 4.0 International License.
