Signs, Dangers and Treatment of a Strangulated Hernia

Understanding Strangulated Hernia

A hernia occurs when an organ or tissue squeezes through a weak spot or tear in the wall of muscle or tissue that holds it in place. Hernias often occur in the abdomen. While hernias are relatively common, they can lead to severe complications if not treated. One such complication is a strangulated hernia.

A strangulated hernia is a serious and potentially life-threatening condition that occurs when the blood supply to the herniated tissue becomes cut off or restricted. This leads to the tissue becoming swollen and inflamed. A strangulated hernia requires emergency surgery in order to prevent tissue death and other dangerous complications.

Signs and Symptoms of Strangulated Hernia

Some of the common signs and symptoms of a strangulated hernia include:

• Severe pain in the area of the hernia, which may come on suddenly
• Inability to push the hernia back into place
• Nausea and vomiting
• Fever and chills
• Rapid heart rate
• Tenderness, redness, and swelling around the hernia
• Constipation and inability to pass gas
• Dark purple or black discoloration of the skin around the hernia

Causes of Strangulated Hernia

Some of the common causes of a strangulated hernia include:

• Incarcerated hernia - An incarcerated hernia is when the herniated tissue becomes trapped outside the abdomen and cannot be pushed back in. This can progress to strangulation.
• Delay in hernia repair - Left untreated, hernias tend to enlarge over time and have a higher risk of becoming strangulated.
• Strenuous physical activity - Heavy lifting, coughing, straining during bowel movements, etc. can cause a sudden increase in abdominal pressure, trapping the herniated tissue.
• Obesity - Increased weight and fatty tissue in the abdomen raise the chances of hernia complications.
• Prior hernia surgeries - Patients who have had hernia repair surgery have a slightly higher risk of developing a strangulated hernia.
• Advanced age - The muscles and tissues weaken as people get older, increasing the chances of hernias.

Risk Factors

Some factors that can increase the risk of a hernia becoming strangulated include:

• Delaying hernia surgery
• Having a very large hernia
• Chronic cough or constipation
• Collagen vascular diseases, such as Ehlers-Danlos syndrome
• Uncontrolled diabetes
• Taking corticosteroid medications
• Older age
• Pregnancy
• Obesity
• Smoking

Dangers and Complications

A strangulated hernia can lead to serious complications if not treated promptly. Some potential dangers and complications include:

• Bowel obstruction - The trapped intestinal tissue may swell and block the intestines.
• Tissue death - Lack of blood flow causes the herniated tissue to die off rapidly.
• Bowel perforation - The blocked intestine may rupture, spilling intestinal contents into the abdomen.
• Sepsis - Bacteria from the perforated bowel can enter the bloodstream and cause a life-threatening infection.
• Severe dehydration - Vomiting, fever, and an inability to intake fluids may lead to dehydration.
• Kidney failure - Dehydration and sepsis can damage the kidneys.
• Death - Without swift emergency treatment, a strangulated hernia can be fatal.

Getting Medical Help

If you suspect you may have a strangulated hernia, it is imperative to seek immediate medical attention. Even if there is a slight chance the hernia is strangulated, it is better to err on the side of caution.

Call an ambulance or have someone drive you to the nearest emergency room right away. The ER doctors will examine you and order imaging tests, like an abdominal CT scan or ultrasound, to confirm the diagnosis and check for complications.

You will likely need urgent surgery to untwist the hernia and release the trapped tissue. Surgery reduces the chances of tissue death and other complications. The hernia defect will also be repaired during the surgery to prevent future recurrences.

In extreme cases where bowel tissue has already died, a section of the intestine may need to be removed. This requires making an open incision on the abdomen rather than doing it laparoscopically.

Preparing for Hernia Surgery

Here are some tips to prepare if you require emergency hernia surgery:

• Inform the surgeon about any medications, supplements, or allergies you may have.
• Stop eating food and only take small sips of water to avoid vomiting during surgery.
• Make any necessary arrangements for work, family, or pets while you recover.
• Remove any jewellery, accessories, contact lenses, dentures, etc. before surgery.
• Discuss anaesthesia choices and pain management with your doctor.
• Ask a family member or friend to drive you to and from the hospital.
• Bring an overnight bag with toiletries, eyeglasses, chargers, comfortable clothes, etc.

Recovery After Hernia Surgery

Recovering from emergency hernia surgery may take longer than a scheduled repair. You will need to take it easy for a few weeks afterwards. Here are some tips for recovery:

• Get lots of rest and avoid strenuous activities.
• Take any prescribed pain medications as directed.
• Hold a pillow against your abdomen when coughing or moving to avoid pain.
• Wear loose, comfortable clothing that does not rub against the incision site.
• Avoid heavy lifting, exercise, and sexual activity for 4-6 weeks.
• Call your surgeon if you have fever, bleeding, persistent pain or nausea.
• Begin gentle activities like walking as soon as you are able.
• Drink lots of fluids and eat smaller, frequent meals as your appetite returns.
• Avoid straining with bowel movements by taking stool softeners or laxatives.

Your surgeon will see you for follow-up appointments and let you know when you can return to your normal activities. Recovery takes time and patience is key. Report any unusual symptoms or problems to your doctor.

Preventing Strangulated Hernia

While hernias themselves often cannot be prevented, you can lower your risk of developing a strangulated hernia by:

• Getting elective hernia surgery as soon as possible after diagnosis.
• Eating a high-fiber diet to prevent constipation and straining.
• Quitting smoking and maintaining a healthy weight.
• Avoiding heavy lifting and building core strength.
• Seeking treatment for chronic coughs or constipation.
• Wearing a supportive truss or hernia belt.

Make sure to watch for any signs of incarceration - inability to push the hernia back in, nausea, vomiting, or severe pain. Seek medical help immediately if these occur.

While hernias may seem like a minor nuisance, they can quickly become an emergency. Recognizing the signs of a strangulated hernia and seeking prompt medical treatment is crucial to preventing catastrophic outcomes. With proper precautions and monitoring, patients can continue to live full, active lives after hernia repair.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.