Discussion of: "Follow-up trends after Emergency Department discharge for acutely symptomatic hernias"

Background: Patients frequently present to the Emergency Department (ED) with symptomatic hernias. This study evaluated the outcomes of patients presenting with symptomatic hernias without indication for immediate operation who are discharged for elective repair. Methods: A three-year retrospective analysis of patients discharged from the ED with a symptomatic hernia was performed at a university affiliated county referral center. The incidences of ED revisits, clinic follow up and repairs occurring in the elective versus emergency setting were assessed. Results: There were 111 patients evaluated and discharged from the ED with a symptomatic hernia where 21% (23) were recurrent and 27% (30) were chronically incarcerated. Of the 111 patients only 23% (26) followed-up in clinic and only 18% (20) underwent hernia repair. However, 25% (28) of all patients required a return visit to the ED and 45% (9) of herniorrhaphies were emergent. Conclusions: Discharge and failure of follow-up after an ED visit for a symptomatic hernia leaves many patients at risk for recurrent ED visits and emergent surgery. (C) 2017 Published by Elsevier Inc.