CLINICAL AND MORPHOLOGICAL FACTORS DETERMINING LETHALITY IN COMPLICATED ABDOMINAL WALL HERNIAS AND THEIR PROGNOSTIC SIGNIFICANCE

Complicated abdominal wall hernias represent a significant clinical challenge in emergency surgery due to their high risk of morbidity and mortality. The progression from incarceration to strangulation leads to impaired blood supply, resulting in ischemia, necrosis, and potentially life-threatening complications such as peritonitis and sepsis. The aim of this study is to identify and analyze the key clinical and morphological factors determining lethality in patients with complicated abdominal wall hernias, as well as to evaluate their prognostic significance. The study is based on a comprehensive analysis of patients admitted with complicated hernias requiring urgent surgical intervention. Clinical parameters such as age, duration of symptoms, comorbidities, and the presence of systemic inflammatory response or sepsis were assessed. In addition, intraoperative and histopathological findings, including bowel ischemia, necrosis, vascular thrombosis, and peritoneal contamination, were evaluated to determine their impact on patient outcomes. The results demonstrate that advanced age, delayed hospital admission, and the presence of comorbid conditions significantly increase the risk of mortality. Among clinical factors, sepsis and septic shock were identified as the strongest predictors of poor outcomes. Morphological factors such as transmural bowel necrosis, perforation, and generalized peritonitis were also strongly associated with increased lethality. The integration of clinical and morphological data provides a more accurate approach to predicting patient prognosis and guiding treatment strategies. In conclusion, early diagnosis, timely surgical intervention, and comprehensive evaluation of both clinical and morphological factors are essential for reducing mortality in patients with complicated abdominal wall hernias. The findings of this study highlight the importance of a multidisciplinary approach and the development of prognostic models to improve clinical outcomes.