Strangulated Hernia in Adults, a Persisting Surgical Emergency: Epidemiology and Management at Tengandogo University Hospital (Burkina Faso)
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 single-centre, retrospective observational cohort 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; over the study period, strangulated hernia accounted for 4.96% of abdominal surgical emergencies at Tengandogo University Hospital. The mean age of patients was 44 years, with a male predominance (sex ratio = 2.18). Manual workers (farmers and labourers) accounted for 49.0% of patients. Clinically, all patients presented with a tender, irreducible hernial swelling. 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. Among the 70 patients operated on for a groin hernia, residual pain was reported in 15 (21.4%) and recurrence in seven (10.0%) at six months. Residual pain was more frequent after Bassini repair and recurrence after McVay repair; given the very small subgroups and the number of comparisons performed, these associations should be regarded as exploratory. Conclusion: Reducing consultation delays and improving access to elective surgery are major challenges to limit these complicated forms. When they occur, a selective policy of mesh repair, in the absence of bowel necrosis or gross peritoneal contamination, proved feasible and was not associated with an excess of infectious complications; the lower rates of residual pain and recurrence observed after mesh repair should be regarded as exploratory given the small number of events.
Downloads
PlumX Statistics
References
Amougou, B., Eyongeta, D., Cisse, D., Ngandeu, M. J., Engbang, J. P., Djoufang, R., Beyeme, T. S., Sow, Y., Diallo, A. B., & Iii, F. A. (2021). Les hernies inguinales de l’adulte à l’Hôpital Central de Niete: aspects épidémiologiques et anatomocliniques. Health Sciences and Disease, 22(7). https://doi.org/10.5281/hsd.v22i7.2703
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
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., Sakakushev, B., Augustin, G., Latifi, R., Kelly, M. D., Wani, I., Baiocchi, G., Bala, M., Bendinelli, C., Bulger, E. M., Demetrashvili, Z., Di Carlo, I., Kashuk, J., Sugrue, M., Ivatury, R., Bonavina, L., Manfredi, R., Poiasina, E., Cui, Y., Inaba, K., Fikry, K., Ben-Ishay, O., Faccincani, R., Voiglio, E. J., Coimbra, R., Rossetti, D., Naidoo, N., Weber, D., Abu-Zidan, F. M., & 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
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., Singh, K., Timoney, M., Weyhe, D., & 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
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
Francis, B., Mubezi, I., Kakande, I., Oppong, C., Akoh, J., & Tatumwa, B. D. (2025). Postgraduate surgical hernia training with a standardized hernia surgery training tool: training while serving humanity. Annals of Medicine and Surgery, 87(12), 8304–8308. https://doi.org/10.1097/MS9.0000000000004183
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
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
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
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
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
Köckerling, F., Heine, T., Adolf, D., Zarras, K., Weyhe, D., Lammers, B., Mayer, F., Reinpold, W., & Jacob, D. (2021). Trends in emergent groin hernia repair—an analysis from the Herniamed Registry. Frontiers in Surgery, 8, 655755. https://doi.org/10.3389/fsurg.2021.655755
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
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
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
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., Kamara, T. B., Lavy, C., Lundeg, G., Mkandawire, N. C., Raykar, N. P., Riesel, J. N., Rodas, E., Rose, J., Roy, N., Shrime, M. G., Sullivan, R., Verguet, S., Watters, D., Weiser, T. G., Wilson, I. H., Yamey, G., & 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
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
Ndong, A., Diallo, A. C., Falola, A., Ndiaye, M. A., Faye, M., Faye, P. M., Niasse, A., Fall, S. M. A., Cissé, M., Diop, P. S., & Konaté, I. (2025). Choice of surgical technique in groin hernia surgery among residents in Senegal: experience and influencing factors. Journal of Abdominal Wall Surgery, 4, 14076. https://doi.org/10.3389/jaws.2025.14076
Ndong, A., Tendeng, J. N., Diallo, A. C., Diao, M. L., Sow, O., Mawuli, S. D., Diallo, S., Sarr, N., Sarr, I. S. S., Ndiaye, A., Dia, D. A., Manyacka Ma Nyemb, P., & Konaté, I. (2023). Adult groin hernia surgery in sub-Saharan Africa: a 20-year systematic review and meta-analysis. Hernia, 27(1), 157–172. https://doi.org/10.1007/s10029-022-02669-9
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
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
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
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
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.
Tcheutchoua Soh, G., Gaye, S. A., Faye, P. M., Diallo, T. A. T., Diop, A. K., Tendeng, J. N., Thiam, O., Manyacka Ma Nyemb, P., Toure, A. O., Konate, I., & Cisse, M. (2026). Abdominal wall hernia management in a second level hospital of Senegal: a cross-sectional study. Frontiers in Surgery, 13, 1864822. https://doi.org/10.3389/fsurg.2026.1864822
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. The Lancet, 370(9596), 1453–1457. https://doi.org/10.1016/S0140-6736(07)61602-X
Copyright (c) 2026 Rodrigue Namekinsba Doamba, Mamadou Windsouri, 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.
