Strangulated Hernia

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A hernia gets strangulated when its content is clamped down by the surrounding tissues. This results in cutting off of the blood supply to the contents which may be a part of the small intestine, a fatty tissue etc. It is an emergency because if this strangulation is not relieved on time, it may lead to the death of that portion of the tissue (gangrene). This may lead to the death of the affected person.

Symptoms of strangulated hernia

  1. Swelling of the affected part, indicating the presence of hernia.
  2. Sudden onset of severe abdominal pain which may get worse.
  3. Nausea.
  4. Vomiting.
  5. Constipation.
  6. Passage of bloody stool.
  7. Inability to pass gas.
  8. Fever.

Why does a hernia get strangulated?  

Hernia gets strangulated when the portion of tissue that slipped into the weakened region of the abdomen (hernia sac) is larger than it can contain. Usually, the passage where the herniated tissue passes through is narrower than the inside part of the hernia sac.

Thus the strangulation occurs at the narrowed portion of the sac (neck). Some conditions that can lead to strangulation of hernia include the following:

  1. Strenuous activities
  2. Straining while defecating
  3. Pregnancy
  4. Prolonged cough

Treatment for strangulated hernia 

Strangulated hernia is treated by surgery only. It is important the affected person presents on time so that the surgery can take place as soon as feasible, in order to prevent damage to the strangulated tissue.

At surgery, the obstruction is released and the tissue is observed by the surgeon so as to identify any dead portion of the tissue, which might have resulted from the obstruction of blood flow to the tissue. If there is, the dead portion is cut off and the healthy portions are joined together. After this, the hernia will be repaired.

Post-surgery, the duration of hospital stay depends on the associated complications before presentation. After discharge, it is important to keep to doctor’s instructions. Avoid lifting of heavy weight for two to three months after the procedure.

Complications of strangulated hernia

  1. Gangrene – The strangulated portion of the herniated tissue may die (undergo gangrene) from lack of blood supply if the obstruction is not relieved on time.
  2. Sepsis – Numerous bacteria may be released from the dead portion of the tissue into the blood stream, resulting into infection spreading to the whole body through the blood stream, making the person very sick.
  3. Death – The affected person may die from overwhelming sepsis.

Prevention

  1. Prompt treatment of hernia – This will prevent the hernia from getting strangulated.
  2. Early presentation – When the obstruction has already occurred, affected person should present as soon as possible. This will prevent the strangulated portion from becoming gangrenous.
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