Strangulated Hernia in Adults, a Persisting Surgical Emergency: Epidemiology and Management at Tengandogo University Hospital (Burkina Faso)

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.