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Jurnal Kesehatan Tadulako Vol. 1 No.

1, Januari 2015 : 1 - 10

PRELIMINARY hospital that has the number of cases of


An inguinal hernia is a surgical case most inguinal hernia were hospitalized the period
after appendicitis. Until now, this is still a 2010 - 2011 Most ie 269 cases. [4] In 2012,
challenge in improving the health status of the number of cases of inguinal hernia who
the community because of the cost required are hospitalized in the Central Sulawesi is
in handling and loss of labor due to a slow 270 cases.
recovery and recurrence rate. The amount of While the number of cases of inguinal
the costs required for the handling of hernia hernia who are hospitalized in the city of
can also cause the socioeconomic problems. Palu in 2012 is 244 cases. [5] Therefore, the
[1] authors felt it was important to conduct
Of the cases of all types of abdominal research on the characteristics of patients
hernias, 75% of inguinal hernia. Ingunalis with inguinal hernia in Palu Anutapura
lateral hernia was found about 50% while General Hospital in 2012.
the hernia ingunalis medial femoral hernia METHOD
25% and about 15% and 10% more This research is a descriptive research.
abdominal hernia. [2] Bank Indonesia Implementation of this research was
Health Ministry data says that based on the conducted by analyzing secondary data from
distribution of the digestive system diseases medical records of patients with inguinal
according to the category of inpatient hernia in 2012, and considering the rules and
hospital in Indonesia since 2004, hernia ethics of doing research. Sampling was done
ranks 8th with a number of 18 145 cases, by purposive sampling techniques, sample
273 of them died. Of the total, 15 051 of size that have met the inclusion and
which occur in men and 3,094 cases occur in exclusion criteria as many as 80 people.
women. [3] There are eight characteristics were
According to data from the Central Sulawesi examined in this study, namely
Provincial Health Office, the number of sociodemographic (age, occupation, and
cases of inguinal hernia who are hospitalized gender), the chief complaint, classification
in the year 2010 - 2011 is 410 cases. This is based on an exit organ, a classification based
the number of cases of inguinal hernia that on the nature, recurrence, co-morbidities, the
occurs in 6 hospitals in Central Sulawesi. action and the current state of exit.
Palu Anutapura General Hospital is a Preparations of this data is done by editing,

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Jurnal Kesehatan Tadulako Vol. 1 No. 1, Januari 2015 : 1 - 10

coding, entry and tabulating, with the use of Table 4. Distribution of patients according to
SPSS software version 17. The timing of recurrence in inguinal hernia General
this study was conducted in April 2013. The Hospital Anutapura Palu in 2012
study was conducted at the General Hospital Table 4 shows that patients who experience
Anutapura Palu. recurrence of inguinal hernia as many as 1
RESULTS (1.2%) and that did not experience a
Table 1. Distribution of inguinal hernia recurrence amounted to 79 people (98.8%).
patients according to age groups at the Table 5. Distribution of patients according to
General Hospital in 2012 Anutapura Palu the classification of inguinal hernia organ
Table 1 shows that the age group of patients discharge lines at the General Hospital in
with inguinal hernia highest age group> 60 2012 Anutapura Palu
years as many as 28 people (35%), and the Table 5 shows that this type of hernia is the
lowest is in the group of 11-20 years of the 1 highest classification organ discharge path
(1.2%). experienced by patients with inguinal hernia
Table 2. Distribution of patients with is HIL (D) as many as 43 people (53.8%),
inguinal hernia according to the job at and the lowest was HIM (D) and bilateral
General Hospital Anutapura Palu in 2012 inguinal hernia, respectively as many as 1
Table 2 shows that this class of patients with (1.2%).
inguinal hernia highest job is self-employed Table 6. Distribution of patients with
as many as 23 people (28.8%), and the inguinal hernia by classification properties
lowest is in the work of students and Anutapura General Hospital in Palu in 2012
members of the House of Representatives Table 6 shows that the type of hernia highest
namely respectively of 1 (1.2%). classification based on nature experienced
Table 3. Distribution of inguinal hernia by patients with inguinal hernia is reponibel
patients according to sex at the General many as 66 people (82.5%), and the lowest
Hospital in 2012 Anutapura Palu was irreponibel (accreta) as many as six
Table 3 shows that the highest groups of people (7.5%).
patients with inguinal hernias are inguinal Table 7. Distribution of patients with
hernia patients with male sex as many as 79 inguinal hernia by action at the General
people (98.8%), while the lowest are the Hospital in 2012 Anutapura Palu
female sex as many as 1 (1.2%).

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Jurnal Kesehatan Tadulako Vol. 1 No. 1, Januari 2015 : 1 - 10

Table 7 shows that the action of the most the General Hospital in Palu in 2012
widely given to patients with inguinal hernia Anutapura
is operating as many as 76 people (95%), Table 10 shows that the type of the main
and the least was not operating as many as 4 complaints that many complained of
people (5%). inguinal hernia patients treated at the
Table 8. Distribution of Inguinal Hernia hospital when the top is a lump in the groin
Patients According to state on Exit appeared lost as many as 29 people (36.2%)
Anutapura General Hospital in Palu in 2012 and the least is the scrotal sac enlargement
Table 8 shows that the current state of can not be lost as much as 3 people (3.8%)
inguinal hernia patients discharged from the
hospital the most is improved by 76 people DISCUSSION
(95%), and the least was not improved as From the age of 30 years, a person will
much as 4 people (5%). begin to experience penurununan
Table 9. Distribution of Patients with physiological function and change - change
inguinal hernias * According to the in the structure. The decline in physiological
accompanying Diseases at the General function and structural changes lead to
Hospital Anutapura Palu Year 2012 decreased muscle strength or simply
Table 9 shows that comorbidities in patients someone suffering from an illness
suffering from an inguinal hernia inguinal including diseases that cause an increase in
hernia is currently experiencing the most is intra-abdominal or other diseases is one of
hypertension as much as 2 (2.5%) and the the risk factors of inguinal hernia. Besides
least highly variable, namely DM, paralytic the increasing age of a person, will have
ileus, appendix vermivormis necrosis, many activities including doing heavy work.
bronchitis, TB lung, umbilical hernia, According Sjamsuhidajat and Jong [6], the
dyspepsia and anemia respectively of 1 incidence of inguinal hernias increases with
(1.2%). Of all patients with inguinal hernias, age due to increased illness and the hard
there were 70 people (87.5%) who did not work that exalts interabdomen pressure and
have comorbidities when suffering from an reduced the strength of the supporting
inguinal hernia. network. It was also supported by data from
Table 10. Distribution of patients with the Provincial Health Office of Central
inguinal hernia main complaint according to Sulawesi that many patients with inguinal

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Jurnal Kesehatan Tadulako Vol. 1 No. 1, Januari 2015 : 1 - 10

hernia that has aged> 25 years in 2012. [5] or has a chronic illness that can increase
In previous studies, only performed on intra-abdominal pressure after suffering a
children so that there is no comparative data recurrence of hernia that can occur. On the
for the present study. Sjamsuhidajat and lateral inguinal hernia recurrence is most
Jong, [6] states that the self-employed and often the cause is the closure of the internal
farmers is a job that has a high activity level inguinal ring inadequate, such as dissection
and is likely to lift heavy loads and done in a of the hernia bag is less than perfect, etc. On
long time that will lead to an increase in the medial inguinal hernias cause of relapse
intra-abdominal pressure well in a long time, is generally due to excessive voltage at the
which is one factor the risk of inguinal seams plastic or other flaws in technique. [6]
hernia. Earlier studies did not examine the
Of all the research that has been done recurrence rate.
before, and in theory, stating that men are Sondra Napitupulu, [7] states that the
more likely to have an inguinal hernia than location of most of inguinal hernia is a
women. Research on children by Sondra lateral inguinal hernia (100%) and the most
Napitupulu [7] in getting the results 39 that dextra (52.2%). While the results
(84.8%) men and 7 women (15.2%), while obtained by the Sri Ramadhani [8] is an
research conducted by Sri Ramadhani, [8] inguinal hernia dextra 64% and 32% of the
showed 88% male and 12% female. The left inguinal hernia and bilateral 4%.
adult male is more active and lift heavy Inguinal hernias occur on the right side as
loads that increase intra-abdominal pressure much as 60%, 20-25% left side, and bilateral
is a risk factor for inguinal hernia. [9] While 15%. [6] A total of 65% a lateral inguinal
the boys more often than girls because of the hernia and 35% a medial inguinal hernia.
slow closure or obliteration of processus [10] This occurs because the process of
vaginalis testis is a path that led to the fall of testicular descent, testis to the right of the
the inguinal hernia. last decline and usually also the process of
Herniorraphy conducted at research sites are closing of the processus vaginalis does not
already using the correct technique so that happen perfectly.
cases of recurrence is very rare. Besides Causes are more prevalent inguinal hernia
cases of hernia who have a relapse can also hernia reponibel due to be addressed so that
be caused patient is still doing heavy work has not happened adhesions or hernia

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Jurnal Kesehatan Tadulako Vol. 1 No. 1, Januari 2015 : 1 - 10

sufferers have wide rings that do not pinch that causes the healing hernia after surgery
the pockets hernia. Inguinal hernias occur because of blocked or comorbidities and not
ireponibel accreta because of adhesions due because of the healing obstructed inguinal
to fibrosis. Hernia incarcerated (trapped) hernia. Morbidities can also be used to
when it sandwiched by hernia ring so that follow up these patients, for example in
the bag is trapped and can not get back into patients with chronic cough should also
the abdominal cavity. [6] monitor cough experienced because it would
An operation in this case herniorraphy cause the hernia becomes relapse due to
(herniotomy and hernioplasty) an act gold increased intra-abdominal pressure
standard for patients with inguinal hernia. continuously.
[10] While all patients who did not undergo The major complaint of patients complained
surgery due to patient refuses to do surgical of the emergence of an inguinal hernia bulge
therapy. Management of hernia surgery is in the crotch of a good that can be lost
good with diagnosis and proper repair during sleep and are not lost even in a state
techniques and also timely. This is because of sleep. Clinical signs and symptoms of
the action operative measures are the most hernia largely determined by the state of the
appropriate for inguinal hernia. The situation contents of the hernia. Inguinal hernias are
is not improved in the present study due to commonly found in research today is an
inguinal hernia sufferers refuse operative inguinal hernia that is reponibel. In
action and only given conservative treatment reponibel hernia complaint only one was a
while being treated in hospital. lump in the groin that appears on standing,
Research by Ridhuan Ramadan [11] states coughing, sneezing, heavy lifting or
that people who suffer from chronic cough straining, and disappeared after lying down
inguinal hernia more than those who do not while ireponibel hernia complaints of a lump
suffer from chronic cough. In theory, there is in the groin that can not be lost even if lying
no discussion about comorbidities down. [6]
experienced by patients with inguinal hernia. CONCLUSIONS AND
Seeing the presence or absence of RECOMMENDATIONS
comorbidities in patients with inguinal Based on the results of research on the
hernia, can be used to see if the length of characteristics of an inguinal hernia patients
stay is influenced by concomitant disease who are hospitalized in the Hospital

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Jurnal Kesehatan Tadulako Vol. 1 No. 1, Januari 2015 : 1 - 10

Anutapura Palu in 2012, it can be concluded with inguinal hernia is reponibel many as 66
as follows: people (82.5%), and the lowest was
1. By age, the highest number of patients are irreponibel (accreta) as many as six people
in the age group> 60 years as many as 28 (7.5%).
people (35%), and the lowest is in the group 7. Under the action is given in patients with
of 11-20 years of the 1 (1.2%). inguinal hernia, the most widely given to
2. Based on the work, the highest number of patients with inguinal hernia is operating as
patients had a job as a self-employed as many as 76 people (95%), and the least was
many as 23 people (28.8%), the second is not operating as many as 4 people (5%).
the farmer as many as 22 people (27.5%) 8. Based on the current state out of the
and the lowest is the work of students and hospital, state the most is improved by 76
members of the House are each as much as 1 people (95%), and the least was not
(1.2%). improved as much as 4 people (5%).
3. In terms of gender, the number of patients 9. Based on comorbidities, which dididerita
with inguinal hernia that most male sex as by patients with inguinal hernia inguinal
much as 79 people (98.8%), while the hernia is currently experiencing the most is
lowest are the female sex as many as 1 hypertension as much as 2 (2.5%) and the
(1.2%). least highly variable, namely DM, paralytic
4. Based on the recurrence, patients who ileus, appendix vermivormis necrosis,
relapsed by 1 person (1.2%) and the did not bronchitis, pulmonary tuberculosis ,
have a relapse amounted to 79 people umbilical hernia, dyspepsia and anemia
(98.8%). respectively of 1 (1.2%). Of all patients with
5. Based on the classification according to hernia inguinal, there were 70 people
exit the path hernia organ, the most common (87.5%) who did not have comorbidities
type suffered by patients with inguinal when suffering from an inguinal hernia.
hernia is HIL (D) as many as 43 people 10. Under the main complaint, which many
(53.8%), and the lowest was HIM (D) and complained of inguinal hernia patients
bilateral HIL respectively by 1 people currently treated at the hospital was a lump
(1.2%). in the groin appeared lost as many as 29
6. Based on the classification by their people (36.2%) and the least is the scrotal
nature, are mostly experienced by patients

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Jurnal Kesehatan Tadulako Vol. 1 No. 1, Januari 2015 : 1 - 10

sac enlargement can not be lost as many as of employees, especially for inguinal hernia
three (3 , 8%). since a long healing process that will lose
Suggestions for institutional hospitals to employment as a result of a slow recovery
improve health services, especially for and recurrence rate. It should also be noted
doctors to provide good service and the right that job support tools are used so that the
to all patients inguinal hernia good at workers can work easily. There should be
providing action and provide information more research on the characteristics of
and education to patients and families about inguinal hernia as well as the relationship
inguinal hernia and follow up the patient's between these characteristics.
good for hernia or comorbidities that could BIBLIOGRAPHY
lead to a relapse if any. It is also expected to 1. Surya B. Comparison of Pain Post-
be able to write medical record with Hernioplasty Shouldice "Pure Tisue" with
complete and clear. Lichtenstein "Tension Free". Indonesia
Expected to public attention to signs that Medicine magazine. 2006; 211-218.
look for inguinal hernia and immediately 2. Stead LG. First aid for the surgery
went to avoid any complications and a poor clerkships. International edition. The Mc
prognosis if it is given too late action. For Graw-Hill Companies: Singapore; 2003. 3.
people with age> 30 years that are not often MOH. Occurrence SistemCerna Inpatient
lift heavy loads alone but raised by some and Outpatient According Group For
people or lift heavy loads with the aid of a Hospitals in Indonesia. Jakarta; 2004.
conveyance, especially for men who are at 4. General Hospital Anutapura Palu. Profile
greater risk so as not to increase intra- General Hospital Anutapura Palu. RSU.
abdominal pressure. Communities do not Palu: Anutapura. 2012.
take action themselves and even non- 5. Central Sulawesi Provincial Health
medical treatment that would endanger the Office. Data situation Morbidity Inpatient
person's condition because of a hernia can Hospital. PHO. Hammer. 2012.
only be cured by operative action which is Sjamsuhidajat R, Jong WD. Textbook of
the gold standard measure of inguinal Surgery. ed.2. EGC: Jakarta; 2004.
hernia. 7. Napitupulu S. Prevalence of Inguinal
Expected government and employers pay Hernia in Children in Dr H. Adam Malik
more attention to financing health and safety period July 2008 - July 2010. 2010 [Cited

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2013 February 7]. Available from: http: 11. Ramadan R. The relationship between
//repository.usu. chronic cough with Genesis Inguinal Hernia
ac.id/xmlui/handle/123456789/21381 in Adult Patients lateral on Digestion
8. Percentage of Genesis Ramadhani S. Surgery Hospital Dr. Moewardi Surakarta.
Inguinal Hernia lateral in Children in 2010 [Cited 2013 May 29]. Available from:
General Hospital Haji Adam Malik Medan http://fk.uns.ac.id/index.php/abstrakskripsi/c
in 2009. 2009 [Cited 2013 February 24]. etak/383
Available from:
http://repository.usu.ac.id/handle/123456789
/21384 9. Sabiston DC. Textbook of
Surgery. EGC: Jakarta; 2010.
10. Nigam S Nigam VK. Essentials of
Abdominal Wall Hernias. I.K. International
Publishing House Pvt. Ltd: New Delhi;
2010.

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