Small studies suggest an association between abdominal aortic aneurysms (AAAs) and hernias, possibly related to connective tissue weakness. We evaluated the association between AAA and abdominal wall hernia (AWH), using peripheral arterial disease (PAD) patients as controls, in Olmsted County, Minnesota. In a retrospective cohort study we queried the electronic medical records for the diagnosis of AAA. The resulting data were then queried for prevalence of AWH. The same set of queries was repeated for PAD. Occurrence of AWH in the 2 groups was compared using the chi-square test. Of the 187 151 patient records queried, 939 had AAA and 3465 had PAD. Abdominal wall hernia occurred in 157 (16.7%) patients with AAA and in 343 (9.9%) patients with PAD. Abdominal wall hernia was 1.7 times more prevalent in those with AAA versus PAD (P < .0001). A history of hernia may prompt screening for AAA in some patients.
LederleFAJohnsonGRWilsonSE. Relationship of age, gender, race, and body size to infrarenal aortic diameter. The Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Investigators. J Vasc Surg. 1997;26(4):595–601.
2.
CollinJ.Screening for abdominal aortic aneurysms. Br J Surg. 1985;72(2):851–852.
3.
WassefMBaxterBTChisholmRL. Pathogenesis of abdominal aortic aneurysms: a multidisciplinary research program supported by the National Heart, Lung, and Blood Institute. J Vasc Surg. 2001;34(4):730–738.
4.
EllisHCalneSWatsonC.Hernia Lecture Notes: General Surgery: Blackwell publishing Ltd; 2006:240.
5.
LehnertBWadouhF.High coincidence of inguinal hernias and abdominal aortic aneurysms. Ann Vasc Surg. 1992;6(2):134–137.
PapadimitriouDPitouliasGPapaziogasB. Incidence of abdominal wall hernias in patients undergoing aortic surgery for aneurysm or occlusive disease. Vasa. 2002;31(2):111–114.
8.
AdyeBLunaG.Incidence of abdominal wall hernia in aortic surgery. Am J Surg. 1998;175(5):400–402.
9.
RaffettoJDCheungYFisherJB. Incision and abdominal wall hernias in patients with aneurysm or occlusive aortic disease. J Vasc Surg. 2003;37(6):1150–1154.
10.
MusellaMMiloneFChelloMAngeliniPJovinoR.Magnetic resonance imaging and abdominal wall hernias in aortic surgery. J Am Coll Surg. 2001;193(4):392–395.
11.
TakagiHSugimotoMKatoTMatsunoYUmemotoT.Postoperative incision hernia in patients with abdominal aortic aneurysm and aortoiliac occlusive disease: a systematic review. Eur J Vasc Endovasc Surg. 2007;33(2):177–181.
12.
HollandAJCastledenWMNormanPEStaceyMC.Incisional hernias are more common in aneurysmal arterial disease. Eur J Vasc Endovasc Surg. 1996;12(2):196–200.
13.
KurlandLElvebackLNobregaF.Population Studies in Rochester and Olmsted County, Minnesota, 1900-1968. The community as an Epidemiologic Laboratory. Baltimore, MD: The Johns Hopkins University Press;1970:47–70.
14.
PleumeekersHJHoesAWvan der DoesE. Aneurysms of the abdominal aorta in older adults. The Rotterdam Study. Am J Epidemiol. 1995;142(12):1291–1299.
15.
ReitsmaJBPleumeekersHJHoesAW. Increasing incidence of aneurysms of the abdominal aorta in The Netherlands. Eur J Vasc Endovasc Surg. 1996;12(4):446–451.
16.
LederleFASimelDL. The rational clinical examination. Does this patient have abdominal aortic aneurysm?JAMA. 1999;281(1):77–82.
17.
LawM.Screening for abdominal aortic aneurysms. Br Med Bull. 1998;54(2):903–913.
18.
GillumRF.Epidemiology of aortic aneurysm in the United States. J Clin Epidemiol. 1995;48(11):1289–1298.
19.
HansSSHuangRR. Results of 101 ruptured abdominal aortic aneurysm repairs from a single surgical practice. Arch Surg. 2003;138(8):898–901.
20.
GorskiYRicottaJJ.Weighing risks in abdominal aortic aneurysm. Best repaired in an elective, not an emergency, procedure. Postgrad Med. 1999;106(2):69–70. 75–80.
21.
HarrisPL.Reducing the mortality from abdominal aortic aneurysms: need for a national screening programme. BMJ. 1992;305(6855):697–699.
22.
AuerbachOGarfinkelL.Atherosclerosis and aneurysm of aorta in relation to smoking habits and age. Chest. 1980;78(6):805–809.
23.
Screening for abdominal aortic aneurysm. recommendation statement. Ann Intern Med. 2005;142(3):198–202.
24.
van LaarhovenCJBorstlapACvan Berge HenegouwenDPPalmenFMVerpalenMCSchoemakerMC.Chronic obstructive pulmonary disease and abdominal aortic aneurysms. Eur J Vasc Surg. 1993;7(4):386–390.
25.
PleumeekersHJDe GruijlAHofmanAVan BeekAJHoesAW.Prevalence of aortic aneurysm in men with a history of inguinal hernia repair. Br J Surg. 1999;86(9):1155–1158.
26.
McPhailI.Abdominal aortic aneurysm and diastasis recti. Angiology. 2008;59(6):736–739.
27.
AndersonOShiralkarS.Prevalence of abdominal aortic aneurysms in over 65-year-old men with inguinal hernias. Ann R Coll Surg Engl. 2008;90(5):386–388.
28.
MoesbergenTLawARoakeJLewisDR.Diastasis recti and abdominal aortic aneurysm. Vascular. 2009;17(6):325–329.
29.
CannonDJReadRC.Metastatic emphysema: a mechanism for acquiring inguinal herniation. Ann Surg. 1981;194(3):270–278.
30.
SorensenLTFriisEJorgensenT. Smoking is a risk factor for recurrence of groin hernia. World J Surg. 2002;26(4):397–400.
31.
SorensenLTHemmingsenUBKirkebyLTKallehaveFJorgensenLN.Smoking is a risk factor for incisional hernia. Arch Surg. 2005;140(2):119–123.
32.
WaghPVLeverichAPSunCNWhiteHJReadRC.Direct inguinal herniation in men: a disease of collagen. J Surg Res. 1974;17(6):425–433.
33.
AhrensRATroutDLAdamsYL.Effect of exercise and dietary carbohydrate on glucose oxidation in rats. Proc Soc Exp Biol Med. 1971;138(1):382–386.
34.
JorgensenLNKallehaveFChristensenESianaJEGottrupF.Less collagen production in smokers. Surgery. 1998;123(4):450–455.
35.
BaxterBTPearceWHWaltkeEA. Prolonged administration of doxycycline in patients with small asymptomatic abdominal aortic aneurysms: report of a prospective (Phase II) multicenter study. J Vasc Surg. 2002;36(1):1–12.
36.
LongoGMXiongWGreinerTCZhaoYFiottiNBaxterBT.Matrix metalloproteinases 2 and 9 work in concert to produce aortic aneurysms. J Clin Invest. 2002;110(5):625–632.
