An Observational Prospective Study of Adult Patients with Ventral Hernia Presenting As Surgical Emergency in Tertiary Care Hospital

Abstract Background: Ventral hernias, including primary and incisional types, are common surgical problems that may present as emergencies due to obstruction or strangulation. Risk factors such as obesity, previous abdominal surgeries, and comorbidities contribute significantly to their development and outcomes. This study aimed to evaluate the clinical presentation, risk factors, and surgical outcomes of ventral hernias, with special focus on previous surgeries, obesity, and comorbidities, and to compare anatomical and mesh repair techniques. Methods: This prospective observational study was conducted in the Department of General Surgery at a tertiary care hospital from November 2022 to July 2024. Thirty adult patients (>18 years) presenting with ventral hernias requiring emergency open repair were included. Data on demographics, comorbidities, surgical history, intraoperative findings, and postoperative outcomes were collected and analyzed. Results: The mean age of patients was 53.3 ± 8.2 years, with females comprising 80%. Incisional hernia was the most common type (73.33%), followed by umbilical (13.33%). Obesity (26.66%) and hypertension (23.33%) were frequent comorbidities. Mesh repair was performed in 80% of cases, while 20% underwent anatomical repair. The most common hernial contents were omentum and small bowel (40%). Postoperative complications occurred in 30% of patients, with surgical site infection (10%) being most frequent. The mean postoperative hospital stay was 11.9 ± 5.0 days, and mortality was 6.66%. Conclusion: Prolene mesh repair demonstrated better outcomes and lower recurrence compared to anatomical repair, even in emergency settings. Female sex, obesity, and prior lower midline incisions were key risk factors. Early elective repair and optimized management can improve surgical outcomes and reduce morbidity.