What is a strangulated hernia?

A strangulated hernia occurs when the blood supply to the herniated tissue has been cut off. This strangulated tissue can release toxins and infection into the bloodstream, which could lead to sepsis or death. Strangulated hernias are medical emergencies.

Any hernia can become strangulated. A strangulated hernia is a hernia that is cutting off the blood supply to the intestines and tissues in the abdomen.

Symptoms of a strangulated hernia include pain near a hernia that gets worse very quickly and may be associated with other symptoms.

Anyone who suspects they have a strangulated hernia should seek emergency medical care.

Fast facts on strangulated hernia:

  • Strangulated hernias tend to cause severe symptoms.
  • A hernia looks like a noticeable bulge on the skin.
  • Anyone who suspects they have a hernia should see a doctor.

Symptoms

lady holding her stomach in pain. Possible strangulated hernia

One common indication of a strangulated hernia is an easily visible bulge in the areas of the abdomen or pelvis.

Other symptoms that may accompany the bulge include:

  • sudden pain that can quickly become excruciating
  • fever
  • general fatigue
  • inflammation and color changes in the skin near a hernia
  • burning feeling around a hernia
  • nausea
  • vomiting
  • inability to pass gas
  • severe constipation or an inability to have a bowel movement
  • bloody stools
  • rapid heart rate

Anyone who experiences pain near a hernia should see a doctor as soon as possible.

Diagnosis and treatment

Strangulated hernias are often diagnosed in the emergency room, and may be easy to see from visual inspection and the description of symptoms. Doctors may use an imaging test, such as an ultrasound, to check if a hernia is blocking a person’s bowels.

A strangulated hernia should be surgically treated immediately, as this may prevent serious harm to the body and permanent damage to the tissues.

 

Surgery

doctors rushing a patient in a bed through a hospital. Possible strangulated hernia

Surgery for a strangulated hernia occurs in two stages.

First, the surgeon will need to reduce the size of a hernia. The surgeon gently applies pressure to a hernia in an attempt to push the trapped tissues back into the abdominal cavity. They must work quickly to prevent the tissue from being permanently damaged.

After this, the surgeon will remove any damaged tissues.

Once this is complete, the surgeon will repair the weak area of muscle where a hernia pushed through. If a hernia is small, the surgeon may be able to do this with stitches. With large hernias, a surgeon may need to add flexible surgical mesh or tissue for added support to help keep a hernia from recurring.

Hernia types

A hernia is the result of a weakness in the abdominal muscles that hold the organs in place. When these muscles become too weak, organ tissue might push through the muscle, creating this noticeable bulge in the skin. This bulge may disappear or become smaller when a person lies down.

Hernias may also be tender to the touch and can cause discomfort in the upper or lower abdomen or groin, especially when lifting, coughing, or bending over.

Hernias may not cause symptoms in some cases, but it may still be better to treat them early to avoid complications.

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A strangulated hernia is not a type of a hernia, but rather a complication. Some of the more common types of hernias that can become strangulated are:

  • An inguinal hernia: A bulge on either side of the pubic bone.
  • An epigastric hernia: A bulge of fat pushing through the walls of the upper abdomen.
  • A femoral hernia: A lump in the groin or inner upper area of the thigh.
  • Umbilical hernias: A bump in the belly button caused by the intestines protruding through weaker abdominal muscles at the belly button.
  • An incisional hernia: A hernia caused by a surgical wound that has not entirely or correctly healed.
  • A hiatal hernia: A hernia that develops when a portion of the stomach elevates through a defect in the diaphragm. While this type of a hernia can become strangulated, the signs are different and include nausea, pain in the chest after eating and bloating.

Incarcerated hernias

Hernias may become incarcerated when the herniated tissue gets trapped and cannot move back into place, but the blood supply to the tissues has not been cut off. However, incarcerated hernias can easily lead to strangulated hernias.

Incarcerated hernias are not a medical emergency, but should still be treated quickly to prevent them from becoming strangulated.

When to see a doctor

If a hernia does not easily go back into the abdominal cavity, it may be incarcerated. Anyone with an incarcerated hernia should see a doctor, as these hernias can easily become strangulated.

Anyone who suspects they have a strangulated hernia should skip the doctor and seek emergency medical care immediately.

Causes

man sitting on the toilet using his phone

Strangulated hernias can occur at any point in a person’s life. It is even possible for babies to be born with hernias that may or may not strangulate.

The cause of a strangulated hernia is the same as other hernias. The muscle tissue in the abdomen becomes weak, which makes it easier for tissues from the intestines to push through the muscle tissue.

When this happens, the abdominal lining can trap the intestines, which pinches off a bit of organ tissue and causes strangulation.

While strangulated hernias can occur in just about everyone, there are some risk factors to look out for. Risk factors for hernias can include:

  • straining during bowel movements
  • chronic coughing, as with some pulmonary disorders, such as chronic obstructive pulmonary disease (COPD)
  • abdominal surgeries or cesarean deliveries
  • strenuous activity, especially when not lifting correctly
  • pregnancy

People who have had a hernia repaired in the past may also be more likely to get a hernia in the same area later on in life.

Complications

Most complications with strangulated hernias occur because of lack of treatment.

The tissue that has been cut off from the blood supply can quickly die off. This leads to a potentially life-threatening situation, as this dead tissue releases toxins and bacteria into the bloodstream that can cause blood infections, sepsis, and death.

Surgery also carries some risk of complications. Doctors will discuss each person’s options with them, including any risks associated with surgery.

Recovery

Recovering from surgery for a strangulated hernia can take time. Many people will need to spend some time recovering in the hospital.

Many people find they can return to their usual lives within a couple of weeks. If there has been severe tissue damage, recovery may take longer. After surgery, a person will need to limit their physical activity for a period of time that is determined by their doctor.

Complete recovery can vary from a few weeks to several months.

Outlook

When a strangulated hernia is caught early and treated quickly, the outlook is good. People who suspect they have a hernia should see a doctor as soon as possible for diagnosis and treatment. Taking action early on may help avoid potentially dangerous issues.

Anyone who notices the signs of a strangulated hernia should seek emergency medical attention.

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