INTERPARIETAL HERNIAS AFTER APPENDECTOMY

Abstract

Despite of numerous publications, concerning problems of herniology, those that are dedicated to the treatment of hernia after conventional appendectomy are few. Reports about interparietal hernias can be reputed as casuistry. The aim of our study was a research of features of clinical course of interparietal hernias after appendectomy, their structure and optimization of surgical treatment. 11 patients with interparietal hernia were included among them 3 had subaponeurotic hernia, 8 – double-level. Men were 4 patients, women – 7, middle-sized hernia occurred in 5, large in 4, giant in 2 cases. According to EHS classification hernias were L1-2- 3W1L1R0 – 2, L2-3W2L1R0 – 1, L2-3W2L2R0 – 6, L3W1L1R0 – 2. The examination was routine, and in doubtful cases included ultrasound. During the examination the features of clinical picture were revealed: - 6 patients didn`t have complaints on tumor like mass, palpation didn`t show exact size of hernia and a hernia ring. Ultrasound gave information about size of hernia ring and reducibility. The type of surgery depended on the size of hernia ring, if they didn`t exceeded 5 cm there was used autoplasty, if so – alloplasty. It was shown: that features of clinical picture were lack of complaints on tumor like mass, inability to determine the size of hernia and it`s ring. Feature of structure of such hernia is that the size of intermuscular hernia sac is much bigger than the subcutaneous one. It can confuse during surgery and lead to clothing of hernia defect only in external oblique aponeurosis, leaving a problem uncorrected.