Umbilical hernia management in a secondary-level hospital of a sub-Saharan country: A case series

Abstract

African populations are particularly affected by umbilical hernia (UH). Despite this, studies on UH in Africa remain rare. From 1st January 2022 to 30th April 2025, 67 patients were admitted for UH in our centre. This study aims to describe a series of patients with umbilical hernia managed in our institution. Umbilical hernia repairs represented 7.9% of all surgeries. Men accounted for 47.8% of the patients, with a sex ratio of 0.91. The mean age was 20.9 years. Paediatric patients (0–16 years) accounted for 43.3% of the cohort. Multiparity (26.9%) and constipation (10.4%) were the most frequent risk factors. Umbilical pain was the most common presenting complaint (35.8%). Complicated hernias occurred in 6.0% of cases, including strangulation (3.0%) and incarceration (3.0%). Hernias were either medium-sized (2–4 cm) in 35.6% of cases or large (>4 cm) in 35.6%. Surgery was performed as an emergency in 3.0% of patients. General anaesthesia was used in 70.1% of cases, and all patients underwent tissue repair. The suture material used was predominantly absorbable (71.6%). The mean length of hospital stay was 1.20 days. Significant postoperative pain was observed in 2 patients. At the three-month follow-up, the recorded complications were 2 cases of keloid scars and 1 case of hernia recurrence. In conclusion, UH appears to be a common condition in our setting with acceptable short-term outcomes. Large cohort studies with long-term and anaesthetic evaluation are needed to assess recurrence and chronic pain to better determine the optimal treatment.