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CLINICAL FACTORS AFFECTING MORTALITY IN STRANGULATED HERNIA

HAROLD LAUFMAN, Ph.D., M.D.; JORDAN DANIELS, M.D.
AMA Arch Surg. 1951;62(3):365-378. doi:10.1001/archsurg.1951.01250030371006.
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STRANGULATED hernia is one of the few surgical emergencies for which published statistics do not show an appreciable decline in mortality in recent years. This fact has led to a renascence in experimental investigation of the condition in an attempt to search for factors other than those known to respond to present day therapy. The mortality rate reportedly ranges from 20 to 40 per cent in cases presenting interference with circulation of the involved segment of bowel and is over 50 per cent in cases requiring resection.1

These widely quoted high mortality rates for strangulation obstruction and especially for resection, though not necessarily accurate today, still exert an unfortunate influence in that they might perhaps be used to distort the surgical approach to the problem in several ways: (1) the tendency to expect a high mortality rate might falsely justify a death; (2) resection, conceivably a lifesaving measure, might

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