Incarcerated Hernia Explained - Incarcerated Definition

Incarcerated Hernia Explained

June 20, 2019

With a myriad of ailments with similar symptoms, it can be quite confusing to determine one from the other. To make matters worse, each illness is narrowed down into numbers of categories and subcategories. However, it’s vital to identify all these classifications as knowing the exact specifications of disease ups the chance of successful treatment.

The same can be said with a hernia, a common and often minor condition characterized by a lump in the groin, abdomen, diaphragm, navel, or through a surgical scar. This article will provide a detailed definition of an incarcerated hernia, as well as its symptoms, diagnosis, and treatment.

 

What Is a Hernia?

An online article reviewed by Dr. Andrew Gonzalez of Michigan Medicine in Ann Arbor defines hernia as a bulging of tissue, fat, or internal organ through some muscle. Types of hernia include incisional, inguinal, hiatal, and umbilical. Each type is characterized by a different set of risk factors and symptoms. The treatment options for each one also varies. In general, all hernias are relatively easy to diagnose. In fact, manually feeling the lump is the usual method for detecting a hernia.

An incarcerated hernia is a more specific complication classified under inguinal hernia. According to the National Institute of Diabetes and Digestive and Kidney Diseases, inguinal hernia happens when fat or a part of the intestines bulge through the wall of the lower abdomen into the area of the groin.

The Cleveland Clinic states that there are two types of inguinal hernia: indirect and direct. A congenital birth defect in the wall of the abdomen causes an indirect inguinal hernia. On the other hand, direct inguinal hernia is commonly diagnosed in adult men. This type is usually caused by the weakening of the abdominal wall muscles due to natural degeneration and aging or from consistently engaging in strenuous activities, especially those that involve lifting heavy objects.

Most of the time, an inguinal hernia does not lead to health dangers. However, it can cause discomfort and pain, especially when stress is exerted into the area due to certain body movements.

Statistics show that men over the age of 40 have a higher risk of developing an inguinal hernia. In fact, in the United States, an estimated 25% of men are likely to have an inguinal hernia once in their lifetime. This is a large figure in comparison to the 2% of women who may develop an inguinal hernia.

Accordingly, risk factors of an inguinal hernia include being male, family history, previous abdominal surgery, smoking, and a poor lifestyle.

 

Incarcerated Hernia

Although considered rare, there are two main complications of an inguinal hernia that is left untreated and has reached the advanced stages. These are incarceration and strangulation.

An incarcerated hernia happens when part of the intestine or fat becomes attached to the scrotum or groin area, and cannot be pushed back up into the abdomen. A strangulated hernia, on the other hand, occurs when the intestine is “strangulated” and the blood supply fails to reach it. This is considered as a severe condition and a medical emergency that requires an immediate surgical procedure.

A medical review of practitioners of internal medicine, Dr. E. Gregory Thompson and Dr. Brian O’Brien, as well as an expert in family medicine, Dr. Adam Husney, and a specialist of general surgery, Dr. Kenneth Bark provides a more detailed description of incarcerated hernia in an online resource center of Alberta Health Services. The review reports that incarceration occurs when abdominal tissue or a part of the intestine becomes stuck in the hernia sac, consequently leading to the bulging of soft tissue which thrusts through an infirm spot in the wall of the abdomen.

 

Symptoms

Incarceration is associated with symptoms such as abdominal pain, vomiting, nausea, and distension. These complaints are reported to be caused by the confinement of a part of the intestine which makes stool unable to pass through.

According to the same review, an incarcerated hernia can also cause strangulation. This happens when the trapped intestine becomes inflamed, leading to gangrene or the death of tissue. As discussed previously, an immediate surgical operation is required when the intestine becomes strangulated.

As for the general symptoms of inguinal hernia, these include pain in the groin due to movements such as coughing, bending, and lifting, a heavy and burning sensation in the groin, swelling of the scrotum, and a lump in the groin that’s only visible when standing.

There are several types of hernia including incisional, inguinal, umbilical, and hiatal. Each one has a different set of risk factors and treatment options. In general, all types of hernia are relatively easy to diagnose and can usually be detected by simply looking for or feeling the lump.

 

Diagnosis

During a health assessment, your doctor will ask about necessary information such as medical and family history. A physical examination is also needed. The doctor may also instruct you to strain, cough, or bend to make the hernia visible.  X-ray or computed tomography (CT) scan can be conducted to determine if the hernia is incarcerated or strangulated.

 

Treatment

The repair of inguinal hernia is considered a common surgical procedure. The three primary types of inguinal hernia repair include open surgery, laparoscopic hernia repair, and robotic surgery.

  • Open surgery: This procedure involves the use of local or general anesthesia. It entails making an incision in the groin and then pushing the hernia back into the abdomen. The wall of the abdomen is strengthened using sutures and mesh.
  • Laparoscopic hernia repair: A more expensive but less invasive option which allows the surgeon to make smaller cuts that take a shorter time to heal. A laparoscope is a device inserted into the small incision, it has a built-in video camera that enables the surgeon to view the hernia and repair it.
  • Robotic surgery: This procedure also utilizes a laparoscope. However, during robotic surgery, the surgeon sits at a console in the operating room. The position there, he or she handles the instruments and performs the surgical operation.

According to the Cleveland Clinic, some risks of inguinal hernia repair surgery include bleeding, infection, and growing, intense pain. Although experiencing long-term complications appears to be uncommon, examples are nerve damage or return of hernia.

 

Reminders

It’s important to seek immediate attention when you notice symptoms of an inguinal hernia. To prevent complications, don’t leave your hernia untreated for a long time. Consult your doctor if you experience any problems during treatment and attend all of your medical appointments.