A hernia becomes a surgical emergency when the tissue that has protruded through the abdominal wall defect becomes trapped and cannot be pushed back (incarceration), and particularly when the blood supply to that trapped tissue is cut off (strangulation). Without blood supply, the trapped tissue begins to die within hours, and if bowel is involved, this can rapidly become a life-threatening situation. The warning signs of a strangulated hernia are specific and important for every hernia patient to know before they happen. Sudden, severe pain at the hernia site that is distinctly more intense than any discomfort you have experienced from it before is the cardinal symptom. The hernia bulge becomes hard, tender to touch, and cannot be reduced back into the abdomen, even with gentle pressure in the lying-down position. Nausea and vomiting often accompany this, and if bowel is obstructed, the abdomen may become distended. If you experience these symptoms, do not wait until morning, do not take a painkiller to see if it settles, and do not wait for a routine appointment. Go to Aster CMI Hospital's emergency department or call immediately. Time is the critical variable in strangulation: the longer the tissue is without blood supply, the more extensive the damage, and the more complex the surgical repair. A strangulated hernia that reaches the operating table within a few hours may require nothing more than releasing the trapped tissue and repairing the hernia. One that has been developing for twelve hours or more may require resection of necrotic bowel in a contaminated surgical field, which significantly increases both the complexity of the operation and the risk of complications and hernia recurrence.
Written by Dr. Mahesh Channappa, MBBS, MS (General Surgery), MBA (Healthcare Management), FAIS, FIAGES, FALS (Fellowship in Advanced Laparoscopic Surgery), FMBS (Fellowship in Bariatric and Metabolic Surgery), Da Vinci Robotic Surgery Training, UK NHS 3-Year Structured Surgical Training, Lead Consultant, General and Gastrointestinal Surgery, Bariatric Surgery, Minimally Invasive (Laparoscopic/Robotic) Surgery and Laser Proctology, Aster CMI Hospital, 43/2, NH 7, New Airport Road, Sahakar Nagar, Sanjeevini Nagar, Bengaluru, Karnataka 560092 (Monday to Saturday, 9:00 AM to 4:00 PM). 26+ years. Phone: +91 9620354889 / +91 9844816622.
