Complications of a hernia arise when the protruding organ or tissue becomes trapped, compressed, or its blood supply is compromised.

Complications of Hernia – Overview
Definition:
Complications of a hernia arise when the protruding organ or tissue becomes trapped, compressed, or its blood supply is compromised. These complications can lead to significant morbidity and often require urgent surgical intervention.

Major Complications of Hernia:
1. Incarceration
The herniated organ becomes trapped and cannot be pushed back (reduced) into the abdominal cavity.
Symptoms:
Persistent pain and swelling.
Firm, non-reducible hernia mass.
Possible intestinal obstruction if bowel is involved.
Requires urgent medical evaluation and possible surgical intervention.
2. Obstruction
Occurs when a loop of bowel in the hernia becomes compressed, leading to partial or complete bowel obstruction.
Symptoms:
Abdominal distension.
Nausea and vomiting.
Absence of bowel movements or gas passage.
Severe colicky abdominal pain.
Needs emergency surgery if unresolved.
3. Strangulation (Surgical Emergency)
The blood supply to the herniated organ (usually intestine) is compromised, leading to ischemia and necrosis.
Symptoms:
Severe, constant pain that worsens over time.
Redness, tenderness, and warmth over the hernia site.
Systemic signs: fever, tachycardia, hypotension.
If untreated, leads to perforation, sepsis, and death.
Requires immediate surgical intervention to prevent life-threatening complications.
4. Perforation & Peritonitis
In untreated strangulation, the ischemic bowel can rupture, leading to peritonitis.
Symptoms:
Generalized abdominal pain and rigidity (board-like abdomen).
High fever, tachycardia, signs of shock.
Severe systemic toxicity.
Requires emergency laparotomy and bowel resection.
5. Infection & Abscess Formation
Occurs in complicated cases, especially after hernia strangulation or surgical repair.
Symptoms:
Fever, localized redness, swelling.
Purulent drainage if an abscess forms.
Managed with antibiotics and possible drainage.
6. Recurrent Hernia
Hernia reappears after surgical repair due to weak tissue healing or mesh failure.
Risk factors:
Poor surgical technique, obesity, smoking, excessive straining.
Managed with revision surgery, often using mesh reinforcement.
7. Testicular Complications (Inguinal Hernia Specific)
Testicular ischemia or atrophy: Due to compression of testicular vessels in long-standing or complicated inguinal hernias.
Hydrocele formation: Accumulation of fluid around the testicle.
Requires careful evaluation and possible surgical management.
Conclusion:
Hernia complications can range from mild discomfort to life-threatening emergencies. Early diagnosis and timely surgical intervention are key to preventing severe outcomes such as strangulation and bowel perforation.

1. InguinalInguinal, ,
umbilicalumbilical, ,
femoral herniasfemoral hernias
The department of the surgical diseases and transplantology of the
Urganch branch
of the Tashkent medical academy

2. 4
1
2
3
Topography of
the inguinal
triangle

3. Posterior surface of the lower department of
the anterior abdominal wall
1 — m. rectus abdominis; 2 — lig. interfoveolare; 3 — anulus inguinalis profundus; 4 — lig. inguinale; 5 — a.
et v. epigastrica inferior; 6 — лимфатические узлы; 7 — lig. lacunare; 8 — a. et v. iliaca externa; 9 —
foramen obturatorium; 10 — n. obturatorius; 11— a. et v. obturatoria; 12 — ureter dexter; 13 — ductus
deferens; 14 — vesica urinaria; 15 — peritoneum; 16 — fossa supravesicalis; 17 — fossa inguinalis
medialis; 18 — lig. inguinale; 19 — fossa inguinalis lateralis; 20 — plica umbilicalis media; 21 — plica
umbilicalis medialis; 22 — plica umbilicalis lateralis.

4. View of the
oblique
inguinal
hernia

5. View of the direct inguinal hernia

6. Types of the oblique inguinal hernias by A.P. Krimov
begining
channel
Hernia of the spermatic duct Inguinal-scrotal

7. Types of the direct inguinal hernias by N.I.
Kukudjanov
начинающаяся интерстициальная
Пахово-мошоночная

8. Innate Innate ((at the leftat the left) ) and gainedand gained ( (at the rightat the right) )
inguinal herniainguinal hernia

9. Differential signs of oblique and
direct hernias
OBLIQUE INGUINAL HERNIA DIRECT INGUINAL HERNIA
More frequently in young age More frequently in elder age
More frequently at one side More frequently bilateral
Descends to scrotum Seldom descends to scrotum
Pear-look form Round form
Cough pushing sense at the lateral
from the internal inguinal aperture
Cough pushing sense at the direct
from the internal inguinal aperture
Hernia’s bag situates to the outside
from the spermatic duct
Hernia’s bag situates to the inside
from the spermatic duct

10. Surgical access at
the inguinal
hernias

11. Opening of the inguinal channel

12. Opening of the hernia’s bag and setting of
the hernia’s content

13. Liquidation of the hernia’s bag

14. Plastic of the anterior wall of the inguinal
channel by Jirar

15. Plastic of the anterior wall of the inguinal
channel by Spasokukockiy

16. Plastic of the anterior wall of the inguinal channel by
Jirar-Spasokukockiy with the stitches of Kimbarovskiy

17. Plastic of the posterior wall of the inguinal
channel by Bassini

18. Method of performing of the surgical treatment at the
innate inguinal hernias

19. Topography of the femoral triangle

20. View of the femoral hernia

21. Operations, carrying out at the
femoral hernias
Operations, carrying
out from the inguinal
access
Rudgy’s method
Rudgy-Parlavechcho’s
method
Raikh’s method
Praxin’s method
Operations, carrying
out from the femoral
access
Lockwood’s method
Lockwood-Bassini’s method
Lockwood-Krimov’s method
Abrajanov’s method

22. Accesses at the femoral hernias

23. Rudgy’s methodRudgy’s method

24. Raykh’s methodRaykh’s method

25. Praxin’s method

26. Lockwood’s methodLockwood’s method

27. Lockwood-Bassini’s methodLockwood-Bassini’s method

28. Abrajanov’s methodAbrajanov’s method

29. Surgical anatomy of the umbilical
hernias

30. Accesses at the umbilical herniaAccesses at the umbilical hernia
1- by Sapejko
2- by Meyo
3- by Lexer

31. Plastic by Lexer

32. Plastic by Sapejko

33. Plastic by Meyo

34. Hernias of the white line of the abdomen
1 – preperitoneal lipoma
2 – starting form of the hernia
3 – formed hernia
1
2
3

35. Intraperitoneal method by Voznesenskiy

36. Extraperitoneal method by
Shampin’oner