You've probably heard of a 'hernia', right? Sometimes we hear that one of our relatives or friends has developed one. Most of the time, when we hear about a hernia, some people think that it's not that big of a deal. However, hernias also have a dangerous side, and that is when the hernia becomes 'strangulated'. Today, we're going to talk about what happens when a hernia becomes strangulated, which is medically speaking, when a (strangulated) hernia occurs. This is not something to be taken lightly, because this is an emergency that can affect life.
What exactly is a strangulated hernia?
Simply put, a hernia is when tissue inside our abdomen, sometimes the intestines, protrudes through a weak spot in the abdominal wall. It looks like a small lump when viewed from the outside, and you can feel it. Sometimes you can push this lump back in, or it will go back in on its own.
But, this hernia is blocked, which means that the blood flow to that protruding part of the tissue, especially to a part of the intestine, stops . You know, every tissue in our body needs oxygen to live, and that oxygen is carried by the blood. So when the blood flow stops, those tissue parts don't get oxygen. Then those tissues start to die . Doctors call this (Necrosis) . This tissue death can cause two very dangerous conditions:
1. (Gangrene ): This means the tissue rots.
2. (Sepsis ): This means that germs have spread throughout the body and the body's systems begin to malfunction.
Both of these conditions are life-threatening. But, rest assured, not all hernias get incarcerated like this. It takes a while for that to happen. We'll talk about how that happens in a moment.
How do you know for sure if a hernia is incarcerated? What are the symptoms?
If you have a hernia and suspect it is strangulated, look out for these symptoms:
- A lump in the abdomen or groin is very painful. You may not be able to put it in before, but you may not be able to do so now.
- Nausea and vomiting are coming.
- Severe pain in the stomach or groin. This pain gradually increases and does not subside.
- The skin color changes where the lump is. The area may become red, purple, or darker than normal.
The most important thing: If you have any of these symptoms, you should go to a hospital immediately without wasting time.
How long does it take for a hernia to become incarcerated?
This is a very dangerous situation. A section of intestine that is stuck in a hernia can lose its blood supply and begin to die within as little as four hours. That's why prompt treatment is so important.
Why does a hernia get stuck like this? What is the reason?
First, let's understand how a hernia forms. Our stomach is surrounded by a wall made of muscles. Some parts of this wall can become weak. Then, the tissues inside the stomach, parts of the intestine, etc., push out through that weak spot. That's what we call a hernia. Then, it looks like a lump from the outside.
Now, sometimes this hernia that has come out can't go back in and can get stuck in that weak spot. This is called an (Incarcerated Hernia) . At this point, blood is still flowing, so it's not a big problem. However, as this incarcerated hernia gradually grows, the pressure from the abdominal muscles can squeeze the blood vessels that go to the tissues inside the hernia. Just like when you squeeze a water pipe too hard, the water stops flowing. That's when the blood flow stops completely, and the hernia becomes a dangerous condition called a "strangulated hernia."
Imagine, Uncle Sumanapala in our village had a hernia in his groin since he was a child. He didn't pay much attention to it. He thought, "That's just how it is." He also did heavy work. One day, he had unbearable stomach pain and started vomiting. The area where the lump was on his stomach turned red and painful. That's when the doctors said, "The hernia is stuck and needs to be operated on quickly." Luckily, he was taken to the hospital quickly, so he survived. But if it had been a little late... I can't even imagine.
How does a doctor accurately diagnose a strangulated hernia?
When you go to the hospital, a doctor will first do a physical examination . They will ask you about your symptoms and any previous illnesses you have. Then they may do some tests, such as:
Tests to diagnose the disease
- Complete Blood Count (CBC) and Basic Metabolic Panel (BMP) : These check the number of white blood cells in your blood (to check for infection) and other important things in your blood.
- CT Scan (Computed Tomography - CT scan) : This can clearly see the condition of the hernia, whether parts of the intestine are blocked or damaged.
- Abdominal Ultrasound : This can also give some idea of the hernia and the surrounding tissue.
How do you treat a strangulated hernia?
The main and only treatment for a strangulated hernia is surgery . Most often, it is called open hernia repair surgery .
In this, the surgeon makes a small incision where the hernia is and carefully places the trapped tissue back inside the abdomen. Then, the weakened area in the abdominal wall is closed with stitches. Sometimes, a mesh- like structure is used to strengthen the muscles.
However, if the hernia is blocked and a section of the intestine is cut off from blood supply and is damaged or dies, then the damaged section of the intestine will have to be removed. This may require a small bowel resection or a colon resection surgery . This is a bit of a major surgery.
Are there any complications of hernia surgery?
Like any surgery, surgery to repair a strangulated hernia carries some risks, or complications. However, these do not happen to everyone.
- Damage to blood vessels, other organs, or tissues near the surgical area.
- Hematoma (blood accumulation under the skin) at the surgical site.
- Fluid accumulation under the skin at the surgical site (Seroma).
- Surgical Site Infection .
If something like this happens, the doctors will provide the necessary treatment.
How long does it take to recover after surgery?
You will need to stay in the hospital for a few days after the surgery. The time it takes to fully recover from surgery to repair a strangulated hernia varies from person to person. It depends on your condition and the nature of the surgery.
You will usually be able to resume your daily activities within a few days after hernia surgery. However, heavy lifting will be off-limits for a while. If lifting is essential to your daily activities, talk to your surgeon about it. He or she will tell you how long it will be safe to lift weights.
However, as I mentioned earlier, if you had surgery to remove a section of damaged intestine, it can take up to six weeks to recover. Your doctor will explain to you what to expect, what to do, and what not to do during your recovery.
What can you expect if you have a strangulated hernia?
A hernia that has become incarcerated usually resolves after surgery. However, it is possible for a hernia to recur. If you have had hernia surgery before and have symptoms of a hernia again, see a doctor immediately. If a new hernia is diagnosed and treated quickly, it can be prevented from becoming incarcerated.
What is the survival rate for someone with a strangulated hernia?
This may sound scary, but it's important to know the truth. The sooner you get treatment, the better your chances of survival. But that can vary depending on your general health, age, and whether or not you had to have part of your bowel removed.
If left untreated, the condition is very dangerous. If a strangulated hernia causes sepsis (the infection that spreads throughout the body) or gangrene (the death of tissue), it can be fatal.
- In cases of gangrene caused by a bacterial infection, death can occur within 48 hours .
- Sepsis is our body's overreaction to an infection. If left untreated, a severe form of sepsis , known as septic shock , can lead to death within 12 hours .
That's why I say again and again, if you have symptoms of a strangulated hernia, go to the hospital without delay .
Can a hernia be prevented from becoming incarcerated?
Yes, it is preventable! This is the best news. If you think you have a hernia, talk to a doctor about it. He or she will examine you and tell you whether or not you need surgery. Some hernias do not get incarcerated very quickly, but some are more likely to get incarcerated. Therefore, it is best to seek the advice of a doctor. Then the hernia can be fixed before it becomes incarcerated or strangulated.
When should I see a doctor?
If you have a hernia, be sure to see a doctor to discuss treatment.
However, if you think your hernia is strangulated, meaning you have these symptoms, go to the nearest hospital emergency room immediately. Or call 1990 (emergency number).
- A sudden, severe pain.
- A change in the color of the skin around a lump in the abdomen or groin (first becoming pale, then becoming darker or red/purple).
Finally, the most important thing to remember (Take-Home Message)
A simple hernia is very common and most of the time, it is not very dangerous. However, a strangulated hernia is a rare but very dangerous, life-threatening medical emergency.
If you think you have a hernia, don't hesitate to talk to a doctor about it. Don't just sit there wondering, "What is that?" Your doctor will explain to you how likely your hernia is to become incarcerated and what you can do to prevent it. Taking quick action could save your life.
` Hernia, Strangulated Hernia, Intestinal Strangulation, Hernia Surgery, Emergency Treatment, Abdominal Pain
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