The Difference Between an Incarcerated Hernia vs Strangulated

A hernia occurs when an internal organ, such as part of the intestine, pushes through a weakness or hole in the muscle of the abdominal wall. Hernias occur in the groin, umbilical region and under scars of previous abdominal surgery.

Most abdominal wall hernias are painless and some cause intractable pain.

Some common sensations include:

A noticeable bulge at the site of the hernia, especially when standing or straining.

Pain or discomfort when lifting heavy objects, bending over, or coughing.

A feeling of weakness or pressure in the affected area.

Burning or aching around the protrusion.

Sometimes the pain can get worse and be unrelenting. This scenario can be worrisome for an incarcerated hernia and urgent surgical repair may be indicated.

An incarcerated hernia occurs when the contents of the hernia become trapped or incarcerated in the hernia itself. Often what is incarcerated in the hernia is internal fat and this can be painful but rarely dangerous. Sometimes the intestine is what becomes incarcerated in the hernia. This is potentially a dangerous situation that will require a surgical solution. The incarcerated intestine can obstruct or block the intestine . An intestinal obstruction from a hernia can present with generalized abdominal distension,pain, nausea and vomiting. This does not necessarily involve compromised blood flow like a strangulated hernia, but it can progress to strangulation if untreated.

• Symptoms: Discomfort, tenderness, swelling, and a bulge that cannot be pushed back in, but generally without the severe pain or signs of infection seen with strangulation.
• Complications: Prolonged incarceration may lead to strangulation, bowel obstruction, and damage to the affected tissue.

A strangulated hernia occurs when the intestine is incarcerated for a prolonged period of time. Over time the pressure on the intestine generated by the hernia that it is caught in - can “strangulate the contents” by taking away its blood supply. When the blood supply to the herniated tissue is cut off - it can lead to tissue death (necrosis). This is a medical emergency that requires immediate surgical intervention. The lack of blood flow can lead to gangrene, infection, or sepsis if not treated promptly.

• Symptoms: Severe pain, redness, swelling, nausea, vomiting, and the inability to pass gas or have a bowel movement.
• Causes: Long-standing, untreated hernias or sudden increases in pressure within the abdomen.
• Complications: If left untreated, a strangulated hernia can cause life-threatening conditions such as necrosis of the bowel, sepsis, and potentially fatal infections.

When it comes to treating incarcerated or strangulated hernias, experience matters. Surgeons specializing in hernia repair bring a deep understanding of the anatomy and can offer advanced treatment options, including minimally invasive approaches.