Manual Closed Reduction of Incarcerated Hernia: Is It Safe in the Emergency Department?
Emergency Medical Services
/ methods
Emergency Service, Hospital
/ statistics & numerical data
Female
Hernia, Abdominal
/ complications
Herniorrhaphy
/ adverse effects
Humans
Intestinal Perforation
/ diagnosis
Israel
/ epidemiology
Laparotomy
/ adverse effects
Male
Middle Aged
Outcome and Process Assessment, Health Care
Postoperative Complications
/ diagnosis
Reoperation
/ methods
Retrospective Studies
Risk Adjustment
/ methods
Risk Factors
Journal
The Israel Medical Association journal : IMAJ
ISSN: 1565-1088
Titre abrégé: Isr Med Assoc J
Pays: Israel
ID NLM: 100930740
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
entrez:
25
1
2022
pubmed:
26
1
2022
medline:
1
2
2022
Statut:
ppublish
Résumé
Emergency surgical repair is the standard approach to the management of an incarcerated abdominal wall hernia (IAWH). In cases of very high-risk patients, manual closed reduction (MCR) of IAWH may prevent the need for emergency surgery. To evaluate the safety, success rate, and complications of MCR in the management of IAWH conducted in an emergency department. The data of all patients who underwent MCR between 2012 and 2018 were retrospectively collected. Patient demographics, presenting symptoms, clinical parameters, and management during the hospitalization were retrieved from the medical charts. Overall, 548 patients underwent MCR during the study period. The success rate was 25.4% (139 patients). One patient had a complication that required a laparotomy 2 days after his discharge. A recurrent incarceration occurred in 23%, 60% of them underwent successful repeated MCR and the others underwent emergency surgery. Six patients (1.4%) had a bowel perforation after a failed MCR. MCR can be performed safely in the emergency department and should be consider as an option to treat IAWH, especially in high operative risk patients.
Sections du résumé
BACKGROUND
BACKGROUND
Emergency surgical repair is the standard approach to the management of an incarcerated abdominal wall hernia (IAWH). In cases of very high-risk patients, manual closed reduction (MCR) of IAWH may prevent the need for emergency surgery.
OBJECTIVES
OBJECTIVE
To evaluate the safety, success rate, and complications of MCR in the management of IAWH conducted in an emergency department.
METHODS
METHODS
The data of all patients who underwent MCR between 2012 and 2018 were retrospectively collected. Patient demographics, presenting symptoms, clinical parameters, and management during the hospitalization were retrieved from the medical charts.
RESULTS
RESULTS
Overall, 548 patients underwent MCR during the study period. The success rate was 25.4% (139 patients). One patient had a complication that required a laparotomy 2 days after his discharge. A recurrent incarceration occurred in 23%, 60% of them underwent successful repeated MCR and the others underwent emergency surgery. Six patients (1.4%) had a bowel perforation after a failed MCR.
CONCLUSIONS
CONCLUSIONS
MCR can be performed safely in the emergency department and should be consider as an option to treat IAWH, especially in high operative risk patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM