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. Complications of the
hernias of the abdomen
The department of the surgical diseases and transplantology of the
Urganch branch
of the Tashkent medical academy

2. Complications of the hernias Complications of the hernias
of the abdomenof the abdomen
Strangulation
Unsetting
Inflammation
Coprostasis
Complications at 10-15% of
hernia-carrier

3. Types of the strangulation of the
hernias
Excrement
strangulation
Elastic strangulation

4. Retrograd
ctrangulation

5. Near-wall (Richter’s) strangulation

6. Clinic of the strangulated Clinic of the strangulated
herniahernia
•Sharp begining
•Pain in the area of hernia
•Unsetting of the earlier setting hernia
•Sharp painful, compaction, effort of the
hernia
•The symptom of «cough pushing» is
negative

7. Stages of the operation at the Stages of the operation at the
strangulated herniastrangulated hernia
1.1.Tightly section of the tissues to the Tightly section of the tissues to the
aponeurosis and stripping of the hernia’s aponeurosis and stripping of the hernia’s
bagbag
2.2.Opening of the hernia’s bag, liquidation Opening of the hernia’s bag, liquidation
of the hernia’s water, keeping of the hernia’s water, keeping
strangulated organstrangulated organ
3.3.Section of the strangulative ringSection of the strangulative ring
4.4.Identification of the vitality of the Identification of the vitality of the
strangulated organsstrangulated organs
5.5.Resection of the not viable organsResection of the not viable organs
6.6.Plastic of the hernia’s gatesPlastic of the hernia’s gates

8. Signs of not viable intestine
•Absence of the peristaltic
•Absence of the pulsation on the
mesenterial vessels
•Blue-black color
•Absence of the briliance of the peritoneum

9. Tests to indentify the vitality of
the intestine
•Novocain test
•Mechanical test
•Test with the «hot compress»

10. Separation of the
hernia’s bag
Opening of the
hernia’s gate

11. Section of the strangulative ring

12. Resection of not viable department of the
intestine

13. Intraintestinal anastomosis “side-by-side”
Nasoenteral probe
Intubation of the small
intestine

14. Independent or forcible setting of the
strangulated hernia
It is impossible to define the state
of the strangulated organ
Possibility of setting with the
strangulative ring
Possibility of defeat of the
strangulated organ

15. Complications of the forcible setting
of the hernia

16. Inflammation of the herniaInflammation of the hernia
Sources of the infection of the hernia’s bag
From the
inside
From the
outside
•Strangulation of the
intestine
•Acute appendicitis
•Diverticulitis
Terminal ileitis
•Typhoid fever’s ulcers
•Perforation of the small
intestine
•Inflammatory processes
of skin
Defeats of the skin
epydedimitis, orchitis
lymphadenitis

17. Unsetting
The complication of the hernias, connected with the formation of The complication of the hernias, connected with the formation of
the soldering among hernia’s bag and hernia’s content as a the soldering among hernia’s bag and hernia’s content as a
result of their trauma or aseptic inflammationresult of their trauma or aseptic inflammation

18. Unsetting

19. Hernia and loose-hanging abdomen

20. Coprostasis Coprostasis
- - stasis of the excrements in the intestinestasis of the excrements in the intestine
The development of the coprostasis
promote:
•Unsetting of the hernia
•Less activity of the life
•Rich feeding
Coprostasis more frequently occurs:
•At fat patients of elder age
•At men at the inguinal hernias
•At women at umbilical hernias

21. Treatment of the Treatment of the
coprostasis coprostasis
•It is necessary to reach the evacuation of It is necessary to reach the evacuation of
the content of the intestinethe content of the intestine
•At setting hernias it is necessary to try to At setting hernias it is necessary to try to
keep the hernia at set statekeep the hernia at set state
•Use small enemas with the hypertonic Use small enemas with the hypertonic
solution, glycerinsolution, glycerin
•The using of the purgatives is The using of the purgatives is
contraindicatedcontraindicated!!

22. Prevention of the Prevention of the
complications of the herniascomplications of the hernias
The surgical treatment of all the
patients with the hernias in
planned regime