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Purpose <p>This retrospective study was conducted to clarify the usefulness of manual reduction (MR) in the management of acute irreducible abdominal wall hernia (AIAWH) in a community-based teaching hospital.</p> Methods <p>The study involved 98 patients who underwent MR for computed tomography-proven AIAWH in our hospital between April 2014 and May 2022. The primary endpoint was the success rate of MR, and secondary endpoints included determining the risk factors for failure of MR in inguinal and femoral hernia, number of MR attempts, staff position of the final MR attempter, and rates of perforation and necrosis in the MR success and failure groups.</p> Results <p>Overall, MR was successful in 45 patients (46%), and the success rate varied among hernia types with significant difference: inguinal 75.0% (30/40), femoral 16.7% (5/30), incisional 36.4% (4/11), obturator 0.0% (0/9), umbilical 75.0% (6/8). For inguinal hernia, hernia sac size and the ratio of hernia sac diameter to hernia orifice diameter (sac-to-orifice ratio; SOR) were significantly associated with MR success rate (both, p &lt; 0.001), whereas for femoral hernia, only SOR was associated with MR success rate (p = 0.026). One patient in the MR success group had perforation and necrosis (2.2%).</p> Conclusion <p>MR appeared to be useful and reasonably safe for the management of AIAWH. The success rate was associated with hernia sac size and SOR in inguinal hernia and with SOR in femoral hernia.</p>

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Evaluation of usefulness of manual reduction in the management of adult acute irreducible abdominal wall hernia: a study from a community-based teaching hospital

  • 期刊论文

  • 发表日期：

    2026年5月12日

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  • Koichi Jinushi,
  • Yozo Suzuki,
  • Kiyotaka Hagihara,
  • Kazuki Odagiri,
  • Yasufumi Sato,
  • Toshiki Noma,
  • Katsunori Matsushita,
  • Naoki Shinno,
  • Masafumi Yamashita,
  • Yoshitomo Yanagimoto,
  • Mitsuyoshi Tei,
  • Junzo Shimizu,
  • Tomono Kawase,
  • Hiroshi Imamura

摘要

Purpose

This retrospective study was conducted to clarify the usefulness of manual reduction (MR) in the management of acute irreducible abdominal wall hernia (AIAWH) in a community-based teaching hospital.

Methods

The study involved 98 patients who underwent MR for computed tomography-proven AIAWH in our hospital between April 2014 and May 2022. The primary endpoint was the success rate of MR, and secondary endpoints included determining the risk factors for failure of MR in inguinal and femoral hernia, number of MR attempts, staff position of the final MR attempter, and rates of perforation and necrosis in the MR success and failure groups.

Results

Overall, MR was successful in 45 patients (46%), and the success rate varied among hernia types with significant difference: inguinal 75.0% (30/40), femoral 16.7% (5/30), incisional 36.4% (4/11), obturator 0.0% (0/9), umbilical 75.0% (6/8). For inguinal hernia, hernia sac size and the ratio of hernia sac diameter to hernia orifice diameter (sac-to-orifice ratio; SOR) were significantly associated with MR success rate (both, p < 0.001), whereas for femoral hernia, only SOR was associated with MR success rate (p = 0.026). One patient in the MR success group had perforation and necrosis (2.2%).

Conclusion

MR appeared to be useful and reasonably safe for the management of AIAWH. The success rate was associated with hernia sac size and SOR in inguinal hernia and with SOR in femoral hernia.