Introduction
A hernia forms where internal tissue squeezes through a muscle wall in the body. In some cases, herniated tissue can be 'reduced', that is gently pushed back through the muscle wall. If this cannot be done, the hernia is referred to as 'non-reducible'. Where this occurs and protruding tissue becomes lodged in place, blood supply to this section of tissue can become cut off – this is a strangulated hernia.
Of all the different types of hernia, the femoral hernia is the most prone to strangulation.
Any strangulated hernia can be a very serious and life-threatening condition as the blood supply is cut off to internal organs. Gangrene can set in quite rapidly causing sepsis and shutdown of internal organs. For this reason, a strangulated hernia is regarded as a medical emergency.
Symptoms
Strangulated hernias have quite different symptoms to non-strangulated hernias. The first noticeable symptom may be a firm visible bulge on the abdomen or pelvis. This is often accompanied by other severe symptoms such as:
- Acute pain (often sudden onset).
- Tenderness and redness of the skin at the site of the hernia.
- Constipation / inability to pass gas.
- Nausea / vomiting.
- Fever.
- Rapid heart rate.
Tests/Diagnosis
As a strangulated hernia causes severe symptoms, they are generally diagnosed by visual inspection and review of symptoms. An ultrasound or CT scan may also be required to check if there is any bowel obstruction.
Treatment
A strangulated hernia can only be treated with surgery. Time is of the essence here as the longer tissue is deprived of blood supply, the more likely it is that gangrene and sepsis will set in.
