AI Article Synopsis
- Inguinal hernias are common and this study aims to analyze the link between single strenuous events and their development through a systematic review of existing literature.
- A total of 5508 records were reviewed, leading to the selection of 5 case series studies, with 255 (26%) of hernias identified as linked to a single strenuous event; however, only 4% met strict causation criteria.
- While many patients believe their hernias resulted from a specific event, applying rigorous criteria shows that only a small fraction can conclusively be connected to such an occurrence.
Article Abstract
Background: Inguinal hernia is a common surgical presentation. Evidence for its causation regarding occupational and recreational physical exposures is limited. The aim of this study is to conduct a systematic review objectively evaluating the evidence for a causal link between a single strenuous event and the development of an inguinal hernia.
Method: A systematic review was carried out in accordance with PRISMA guidelines. PubMed, Ovid Embase, SCOPUS, and Cochrane Library were searched. In addition, the ISRCTN register, ClinicalTrials.gov, ICTR Platform, and EU Clinical Trials Register were searched. Identified publications were collated and both reviewers independently reviewed their contents.
Findings: 5508 records were identified, resulting in 5 studies being selected. These 5 studies were all case series. Of 957 patients identified, 1003 hernias were described, of which 983 were inguinal hernias which 255 (26%) were attributed by patients to a single strenuous event. Only two of these studies applied Smith's Criteria (causation of a hernia from a single strenuous event): officially reported, severe pain at the time of the event, no prior history of inguinal hernia, and the diagnosis was made by a doctor within 30 days (preferably 3 days). Only 2 of 54 patients (4%) met all four criteria and so could be considered as having an inguinal hernia relating to a single strenuous event.
Conclusion: Many patients associate hernias to a single episode, however upon application of more stringent criteria such as Smith's, a much smaller proportion are deemed to be actually attributable to a single strenuous event.
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| http://dx.doi.org/10.1016/j.surge.2018.01.005 | DOI Listing |
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