What is a Strangulated Hernia

Kevin C. Petersen, M.D.

A strangulated hernia is 100% fatal if not treated quickly with surgery. The risks of a hernia repair are much less if treated before it is an emergency. This is why we repair hernias and why watchful waiting is a bad idea for most patients. Strangulation of a hernia is a random event with no reliable early warning signs.

diagram of strangulated hernia

The human abdominal cavity is a remarkably complex and efficient system for taking in nutrients, digesting them and absorbing nutrients into the circulatory system for delivery to all parts of our bodies. Our abdominal cavity and digestive system likely evolved from simple worm like organisms with a mouth at one end, a waste disposal orifice at the other end and a digestive tube in between. Increase in the size of organisms was made possible by compacting and increasing the efficiency and capacity of the digestive system allowing the larger organism to achieve more complex survival strategies.

Intestine trapped inside of a hernia is easily strangulated at its neck at the abdominal wall defect. This causes a bowel obstruction and a blockage of blood flow to the strangulated loop of bowel in the hernia. This then leads to bowel necrosis and perforation. Bowel perforation results in soilage of the abdominal cavity and peritonitis. 

If surgical correction of a strangulated hernia is to be life saving it must be done quickly. It may require resection of the damaged bowel. If perforation has already occurred, IV antibiotics and long hospitalization will be necessary.

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