Systemic inflammatory response syndrome (SIRS) signs, contrast-enhanced CT findings as well as lactate, CPK and D-dimer levels are predictive of bowel strangulation (grade 1C recommendation). Unfortunately, morbidity and mortality rates remain high for patients who undergo emergency repair of abdominal hernias. Early diagnosis of strangulated obstruction maybe difficult, and delayed diagnosis can lead to septic complications. However, in the case of suspected bowel strangulation Bcl-2 inhibitor the benefits outweigh the risks of surgery and patients should undergo immediate surgical intervention. A recent study performed by Martínez-Serrano

et al. prospectively analyzed morbidity and mortality rates following emergency hernia repair [12]. The study population included 244 patients with complicated abdominal wall hernias requiring surgical repair. In this study, the patients were treated according to standardized protocols with detailed actions to be taken during the pre-, intra-, and post-operative periods. Clinical outcomes were compared retroactively to that of 402 patients who had undergone similar procedures before the development and implementation Cilomilast price of the protocols outlined in the study. Results showed higher rates of mortality in patients with acute complication

as their first hernia-related symptom and whose treatment was delayed for more than 24 hours. Thus, the authors concluded that early detection of complicated abdominal hernias may be the best means of reducing the rate of mortality [12]. In 2007, Derici et al. published a retrospective study using univariate and multivariate analysis to investigate

factors affecting morbidity and mortality rates in cases of incarcerated abdominal wall hernias [13]. Using univariate analysis, results showed that symptomatic Buspirone HCl periods lasting longer than 8 hours, the presence of comorbid disease, high American Society of Anesthesiology (ASA) scores, the use of general anesthesia, the presence of strangulation, and the presence of necrosis significantly affect morbidity rates. In contrast, advanced age, the presence of comorbid diseases, high ASA scores, the presence of strangulation, the presence of necrosis, and hernia repair with graft were found to significantly affect mortality rates by univariate analysis; the presence of necrosis, however, was the only factor that appeared to significantly affect mortality rates based on multivariate analysis [10]. A retrospective study was recently published evaluating the risk factors associated with bowel resection and treatment outcome in patients with incarcerated groin hernias [14].