When a Hernia Becomes an Emergency: What You Need to Know

Most hernias don’t cause much trouble at first. In fact, many people walk around with them for years without even realizing it. But when a hernia turns into an emergency, it’s a different story—one that requires immediate action. Understanding when a hernia crosses the line from harmless to hazardous can make all the difference in avoiding serious complications.

While most hernias have no symptoms at all, they do represent some risk of experiencing significant discomfort to even pain to even emergency symptoms. The hernia itself is an opening of the muscular dominant wall, and the problem with the hernia is that intestine or internal fat can move in and out of this hole and in doing so it can cause significant discomfort and even potentially this emergency, we call incarceration or strangulation.This emergency is not silent. It is usually painful and could make one feel distended and nauseated at the same time in this circumstance, emergency care would be necessary.

The emergency hernia surgery itself can vary from a small 2 inch incision for management of a very small hernia to a complete midline laparotomy opening the abdomen and it's entirety. The surgery is usually done for extreme symptoms of incarceration and strangulation. Usually freeing up the hernia, contents and repairing the hernia is all that is necessary, but with some incidents there sometimes requires removal of the part of the intestine if this is itself was strangulated inside of the Hernia. Clearly, the risk of complications will increase dramatically with the need for an emergency intestinal resection.

Severe pain related to a hernia with strangulation of its contents or incarceration of its contents. The reason for surgery is to alleviate the pain, but potentially remove what may have gone into the hernia if it loses his blood supply.

You don’t need to be a doctor to know when something’s wrong. If you have a known hernia—or even suspect one—and start experiencing any of the following, seek medical attention immediately:

Sudden, intense pain at the hernia site

A hernia that becomes firm, tender, or doesn’t reduce when you lie down

Nausea or vomiting that won’t stop

Fever or chills

Abdominal bloating or a feeling of tightness

These are signs your body is sounding the alarm. Don’t ignore them.

Emergency hernia surgery carries higher risks than elective repair. There's more swelling, more inflammation, and often more damage to surrounding tissue. The chance of complications—like infection, wound problems, or chronic pain—is significantly higher. And in the worst cases, you may lose part of your intestine.

That’s why timing matters. Elective hernia surgery, when done before symptoms get serious, is safer, more controlled, and often has a much smoother recovery.

If you’ve been diagnosed with a hernia, talk to your surgeon about whether elective repair makes sense for you. Not all hernias need immediate surgery, but ignoring one entirely is never the right move. Regular follow-up, understanding your body, and knowing the warning signs can help you avoid a midnight trip to the ER.

In short, hernias don’t always wait for the right time to act up. Being proactive is your best defense against an emergency.

If you're concerned about a hernia or want expert guidance on treatment options, Dr. Yunis and the team at the Center for Hernia Repair can help. With decades of experience and a commitment to personalized care, we’re here to help you prevent complications and get back to living fully. Contact us today to schedule a consultation.

Emergency hernia surgery is performed when a hernia causes severe symptoms such as incarceration or strangulation—meaning the tissue is trapped or its blood supply is cut off. The procedure may range from a small incision to a full abdominal surgery, depending on the severity. In most cases, the surgeon frees the trapped tissue and repairs the hernia. However, if part of the intestine is damaged due to lack of blood flow, it may need to be removed, which increases the risk of complications.

A hernia is essentially a hole or weakness in the abdominal wall. Through this opening, internal tissue—often fat or part of the intestine—can slip in and out. When this movement causes discomfort or pain, it’s a sign that the hernia is active and potentially worsening. The real danger begins when that tissue gets stuck (incarcerated) or has its blood supply cut off (strangulated).

Strangulation is a true emergency. When blood flow to a portion of the intestine is cut off, that tissue begins to die. This can lead to severe infection, tissue death, and even life-threatening complications. And the symptoms aren’t subtle—sharp, escalating pain, bloating, nausea, vomiting, and sometimes fever or chills. If you're experiencing these symptoms, do not wait. Go to the emergency room.

Emergency hernia repair isn’t one-size-fits-all. The extent of the surgery depends on the size of the hernia and the severity of the damage inside. In some cases, it’s a small incision to push the herniated contents back into place and close the defect. In more serious situations, surgeons may need to perform a full abdominal surgery (a midline laparotomy) to assess and treat the problem.

If the trapped tissue—usually part of the intestine—has lost its blood supply, it may need to be removed. This adds complexity, risk, and recovery time. The need for bowel resection in an emergency setting significantly increases the chance of complications, including infection, prolonged hospitalization, or long-term digestive issues.

There are a few main reasons:

Incarceration: When tissue gets trapped and can’t move back into the abdomen.

Strangulation: When the trapped tissue’s blood flow is cut off.

Severe pain: Pain that’s persistent or escalating, especially with other symptoms like vomiting, fever, or bloating.

These situations often come on quickly and without warning—even in people who had no previous hernia symptoms. That’s part of what makes hernias dangerous: you might feel fine one day, and be in the ER the next.

Clearly, emergency hernia surgery has a much higher incidence of postoperative complications than elective hernia surgery. The long-term outcome of the hernia itself in terms of durability or potentially chronic pain is also adversely impacted.

The only true way to avoid emergency hernia surgery would be to have an elective hernia repair to prevent it from ever occurring. Consult early with a hernia specialist!