When Do Hernias Become Dangerous?
Hernias in and of themselves aren’t dangerous – they are simply defects or holes in the fascia of the abdomen – thick tissue that keeps all of our abdominal contents in place. Hernias can occur for a number of reasons including genetics, age related wear and tear and excessive straining on the abdomen, whether due to pregnancy, excess weight or obesity, chronic coughing or lifting heavy weights.
The hernia becomes problematic when it allows contents of the abdomen – organs like the large intestine or fat and other tissue to protrude, usually causing a visible or palpable lump somewhere in the abdomen. The most common hernia is an inguinal or groin hernia which most often occurs in men and represents about 80% of all hernias repaired in the United States every year. However, it is interesting to note that only a fraction of those with a hernia actually have them repaired. This means millions of people are living with hernias that they don’t even know about. To that end, we do not screen for hernias if no symptoms are present. Only when a hernia becomes symptomatic, causing a lifestyle impediment as a result of pain or bulging, do we then consider hernia surgery.
However, Hernias Can Become Dangerous.
If the contents of the hernia become trapped in the defect, known as incarceration, this requires urgent evaluation and surgical treatment. However, a rare but dangerous and even fatal complication of a hernia is known as strangulation. This is where the contents of the abdomen that are stuck in the hernia defect have their blood supply cut off. This can result in serious infection that, if left untreated, can ultimately become fatal. Further, strangulated hernia contents require emergency surgery to correct, reducing the effectiveness and safety of the procedure. If part of the large intestine dies, a colectomy may be required in addition to the hernia repair to eliminate the diseased length of intestine.
What are the Chances of Strangulation?
Some hernias are more prone to strangulation than others. Femoral hernias, those that occur in the upper thigh, are most often experienced by women and have a high strangulation rate – upwards of 20%. Repairing these is of upmost importance. Hernias in younger patients may also be more prone to strangulation as the musculature in the area is typically tighter, thus increasing risk. Further, small hernias also increase the chances of strangulation.
It is important to know that for someone of average health and surgical risk, elective hernia repair is extremely successful and very low risk. These risks are minimized by employing a general surgeon with extensive experience in hernia repair as there are variables that must be evaluated based on each patient’s particular circumstance.
To schedule a consultation with one of the hernia surgeons at our office, please contact us and we will be happy to discuss options greater detail.