Large Post-Surgical Incisional Hernias: Case Reports and a Review of Barriers Against Early Presentation and Refusal to Consent to Surgery

Abstract:

Incisional hernias, otherwise known as postoperative ventral hernias, are post-surgical fascial defects in the abdominal wall through which fat and viscera protrude. They are preventable causes of morbidity and mortality commonly encountered in our environment. Only a few patients with incisional hernia seek medical advice and only a handful of them consent to a surgical repair, even in the presence of complications, due to the high cost of treatment and disappointment from previous surgery. In this case series, two patients with complicated large long-standing post-surgical incisional hernias, who declined surgical repairs are presented, and the barriers to early presentation and factors responsible for refusal to consent to surgery in sub-Saharan Africa reviewed.