Abdominal wall hernias in patients with abdominal aortic aneurysmal versus aortoiliac occlusive disease

This study was undertaken to determine the incidence of ventral incisional hernias (VIHs) and inguinal hernias (IHs) in patients with abdominal aortic aneurysmal (AAA) versus those with aortoiliac occlusive disease (AIOD). The medical records of 193 patients (128 with AAA and 65 with AIOD) who had undergone elective aortic reconstruction were reviewed to determine the number and location of abdominal wall hernias (AWHs). Forty-one AWHs (28 IHs and 13 VIHs) were detected in patients with AAA compared to 13 (11 IHs and 2 VIHs) in patients with AIOD. There was a significantly greater incidence of VIHs in patients with AAA versus patients with AIOD (10% versus 3%, P<0.05) and recurrent AWHs (28% versus 19%, P<0.01), but not of IHs (22% versus 17%). Patients with AAA have a higher incidence of VIHs and recurrent AWHs—without a corresponding increase in patient-related risk factors—than patients without aneurysm, suggesting that as yet unidentified etiologic factors may contribute to the development of AWHs in these patients.