Hernia describes a condition where body organs or tissue protrudes through a weakness in the abdominal wall. A noticeable bulge exists at the point of protrusion, and it can be painful and more noticeable during certain activities, such as coughing, and during heavy exertion. A hernia can exist in many states, and it becomes life-threatening when it becomes "strangulated." This occurs when the blood supply to the herniated tissue gets diminished and can result in death of the tissue. This usually requires emergent surgery.
General "Toxic" Appearance
Patients with strangulation tend to appear very sick. They often have pale skin, are weak and fatigued, and can have a weak pulse. This is especially true if the patient is about to enter shock from the death and rupture of involved bowel tissue.
Pain
Strangulation of the hernia always has pain as one of the symptoms. This is due to the inflammatory process that is triggered by decreased blood flow to or death of the involved tissue.
Nausea and Vomiting
These are symptoms that are a result of obstruction where the protruding bowel is pushing through the abdominal wall. As a result, digested food cannot pass through the bowels, goes backward and can be regurgitated.
Decreased Flatus
Passing gas is also decreased and/or absent in patients with a strangulated hernia. Again, bowel obstruction is the cause as none of the gas in the bowels can pass through the obstruction to exit via the anus.
Fever
Patients with strangulated hernias tend to have fever as well. This is also due to the inflammatory process that results from dying/dead tissue that is strangulated. Fever can also point to possible infection of body tissues that were involved in the process.
Shock
This refers to the collapse of the circulatory system that is a result of systemic infection from the death and rupture of the strangulated tissue. Patients have low blood pressure, very rapid heart rate, altered mental status and decreased urine output. This is a dire sign and can often be a cause of death.
References
- "Sabiston Textbook of Surgery, 18th Edition;" Courtney Townsend, R. Daniel Beauchamp, B. Mark Evers; 2007
- "Anesthesiology Clinics;" Emergency and Urgent Surgery; Kevin Schuster, M.D., Kimberly Davis, M.D., Stanley Rosenbaum, M.D.; December 2009
- "Rosen's Emergency Medicine, 7th Edition;" John Marx, M.D., Robert Hockberger, M.D., Ron Walls, M.D.; 2009
