Sonographic Association Between Body Mass Index and Anterior Abdominal Wall Hernias: A Hospital-Based Cross-Sectional Study

Abstract

Background: Anterior abdominal wall hernias are a common surgical condition with significant morbidity, affecting approximately 4–5% of the global population. Increased body mass index (BMI) is hypothesized to contribute to hernia formation by elevating intra-abdominal pressure and weakening the abdominal wall. Despite its clinical importance, limited research has explored the general association between BMI and all types of anterior abdominal wall hernias. Objective: This study aimed to evaluate the association between BMI and the occurrence of anterior abdominal wall hernias using sonographic assessment in a hospital-based population. Methods: A cross-sectional analytical study was conducted at the Department of Radiology, Chughtai Medical Centre, Lahore, from March to September 2024. A total of 200 patients undergoing abdominal ultrasound were enrolled using a convenience sampling method. BMI was categorized into obese (>30 kg/m2) and non-obese (≤30 kg/m2). High-resolution ultrasound (Toshiba Aplio 300, 7–12 MHz linear probe) was used for hernia detection. Data were analyzed using SPSS version 25, with chi-square tests applied for statistical associations. Results: Among 200 participants (mean age 52.36 ± 15.81 years, mean BMI 29.13 ± 4.49 kg/m2), 24 (12.0%) had anterior abdominal wall hernias. Paraumbilical hernias were most common (13 cases, 6.5%), followed by umbilical (6 cases, 3.0%), incisional (3 cases, 1.5%), and epigastric (2 cases, 1.0%). Hernia prevalence was higher in obese individuals (9.3% vs. 6.5%) and females (14.1% vs. 7.7%), but associations were not statistically significant (p = 0.6087, p = 0.1944, respectively). Conclusion: Increased BMI and advancing age were associated with a higher prevalence of anterior abdominal wall hernias, though statistical significance was not established. Sonographic evaluation remains an essential tool for accurate hernia diagnosis, particularly in obese individuals.
Keywords: Abdominal Wall, Abdominal Wall Hernia, Body Mass Index, Hernia, Obesity, Sonography, Ultrasonography.