Strangulated Hernia: Causes, Symptoms, Treatment, Prognosis

What is Strangulated Hernia?

Hernias are a medical term used for any type of abnormal bulges or openings in the abdominal wall fascia. Hernias can develop in any region along the abdominal wall fascia where there is any kind of weakness. However, the most common areas where hernias do develop are the umbilical which is at the anterior abdominal wall, inguinal, and femoral, both of which are in the groin area. There are basically two types of hernias namely reducible and incarcerated.[1, 2, 3]

A hernia is said to be reducible when the contents of the abnormal bulge can be placed back intra-abdominally and if they cannot be placed back then it is termed as an incarcerated hernia. A person is said to have a Strangulated Hernia if the contents of the bulge get necrosed due to lack of supply of blood. The strangulated tissue starts to release dangerous toxins in the blood which can cause sepsis and even loss of life of the person. This is the reason why Strangulated Hernia is a medical emergency and requires immediate treatment.[1, 2, 3]

The symptoms associated with Strangulated Hernia are often quite severe and intense and tend to worsen with time rapidly. A person with any form of hernia should consult with a physician and seek treatment for it as any form of hernia can become strangulated and become life-threatening.[1,2,3]

What Causes Strangulated Hernia?

Anyone of any age can have a Strangulated Hernia. There have also been cases of children born with hernias which at times can even be strangulated. The cause for Strangulated Hernia is same as those with other form of hernias. The abdominal muscles become weak and the tissues from the intestines push through the muscle causing a visible bulge to form. This causes the abdominal lining to entrap the intestines taking with it a piece of organ tissue resulting in strangulation.[3]

Strangulated Hernia can develop in any person but is more common in people with some risk factors. These include excessive straining to pass bowels in a chronically constipated person, frequent bouts of chronic cough, surgical procedures involving the abdomen, improper lifting techniques, and pregnancy. People with a past history of any form of hernia are also at risk for developing Strangulated Hernia later in life.[3]

What are the Symptoms of Strangulated Hernia?

The primary feature of a hernia is a palpable and visible bulge around the abdomen and pelvis. Some of the other symptoms of Strangulated Hernia include sudden onset acute pain in the stomach or abdomen that worsens. The patient will also have fever and will always feel fatigued.[3]

The area around the hernia will have prominent skin discoloration. Other generalized symptoms include nausea and vomiting, severe constipation, blood in the stools, and tachycardia. If a person experiences excruciating pain around the hernia site then he/she should see a physician right away to rule out the possibility of a Strangulated Hernia.[3]

How is Strangulated Hernia Treated?

The pain caused due to strangulated hernia is so severe that often the patient ends up in the emergency room. Strangulated Hernia can be easily diagnosed just by visual inspection and the symptoms experienced by the patient. Radiographs can also be done to confirm the diagnosis. With regard to treatment options, emergent surgery is the way to go. This is because any delay in the treatment may lead to serious complications and permanent damage to the tissues.[3]

The surgical procedure to treat Strangulated Hernia occurs in two stages. The first phase of the procedure involves reducing the size of the hernia. For this, the surgeon tries to push the hernia back inside the abdominal cavity gently. This should be done immediately upon arriving to the emergency to protect the tissues. Once this is done, any damaged tissues will be removed. After which the weak area of the abdominal wall is addressed.[3]

If the size of the hernia is small, it can be treated just by stitches. However, if the hernia is big then the surgeon will place a mesh to prevent the hernia from reoccurring again.[3]

What Is The Prognosis Of Strangulated Hernia?

When it comes to the recovery time from hernia surgery, it generally takes some time before the patient is able to carry out normal activities. Generally, it takes upwards of anywhere between two to three weeks before the patient can start normal activities. Recovery may be prolonged in cases where there is significant tissue damage.

Postsurgery, the patient will have to limit the activities that they may be doing prior to the procedure for a period of time until their physician gives them the go ahead. In some cases, complete recovery following surgery for strangulated hernia may take even a few months.[3]

With regard to the prognosis, if Strangulated Hernia is diagnosed and treated quickly then the prognosis is quite good. However, it is imperative for the patient to seek immediate medical consultation if he or she suspects to have a hernia. Early diagnosis and treatment is the key for preventing any permanent tissue damage and other potentially serious complications. For people with Strangulated Hernia, seeking emergency care is the best way to deal with the condition.[3]

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