Anthropology of Inguinal Hernia

ABSTRACT

Introduction: Inguinal hernias are among the most commonsurgical problems worldwide. Hernias, defined as theprotrusion of a whole or part of an organ through the containingwall, along with difficult childbirth and problematic bowelevacuation are thought to be the price we pay for adopting thebipedal gait from previously crawling on all fours. The aim ofthis study was to analyse the anthropological characteristics ofpatients with inguinal hernias, so as to determine the influenceof behavior, evolutionary development and flawed physiologyof their pathogenesis, and thereby identify potential domainsfor risk reduction.Material and Methods: This was a non-interventional,retrospective study. 100 consecutive patients electivelyoperated for inguinal hernias were included and theirclinical profiles studied. The details of their demography andpresentation were tabulated and analyzed.Results: Inguinal hernia had an overwhelmingly malepreponderance, with 99% of patients being male. The meanage of patients at presentation was 56.5±13.27 years. In 93% ofpatients the condition was unilateral, where as it was bilateralin 7%. Right sided hernia was more common with 49% ofcases, left side was involved in 44%. 49% were found to bedirect hernias, 36% were indirect and 8% were pantaloonshernias, with the remainder being bilateral hernias. Rightsided direct hernias were the most commonly encountered,accounting for 28% of the cases, followed by left indirecthernias which were seen in 24%.Conclusions: The epidemiological profile of inguinal herniasin the study population translate to statistically significantfindings with respect to demographic features and risk factorsfor inguinal hernias, well elucidating the anthropology ofthe condition. This study showed statistically significantassociation between inguinal hernia and high BMI, olderage and positive family history, rather than the conventionalsuggestion that increased intra-abdominal pressure is the majorrisk factor. Thus, the role of anthropology and physiographyin the development of inguinal hernias cannot be overlooked.