The most common types of hernias involve the abdominal wall, and you can usually see or feel a bulge under your skin where your intestine or other tissue has pushed through weakened muscle. Even minor hernias can cause intense discomfort or pain, especially when you’re straining — such as during physical activity, when you lift a heavy object, or if you have a difficult bowel movement. Usually, it’s possible to push a hernia back inside the muscle layer it was sticking through — even if it doesn’t stay put. But complications can develop in which a hernia gets trapped and can’t be pushed back. In the most severe of these cases, the tissue in a hernia can lose its blood supply, die, and become infected. This is a medical emergency that typically requires immediate surgery. (1) Even if the hernia doesn’t develop complications on its own, you may experience complications from hernia repair surgery. But surgical complications are more likely if a hernia needs an emergency repair. (2) If left untreated, it’s common for a hernia to get bigger and more painful. And the longer you have a hernia, the greater your risk of developing complications. There are two main complications that can develop in untreated hernias: obstruction (also known as incarceration) and strangulation. (1)
Obstructed Hernia
A hernia becomes obstructed when part of your intestine gets stuck in the muscle layer it’s pushing through. For inguinal hernias, the section of intestine gets trapped in an area of muscle called the inguinal canal. Symptoms of an obstructed hernia may include:
NauseaVomitingAbdominal painA painful lump in your groin area
An obstructed hernia, if left untreated, can develop into a strangulated hernia. (1,3)
Strangulated Hernia
A hernia becomes strangulated when blood flow to the obstructed (trapped) section of your intestine or other tissue is cut off. This condition can be life-threatening if it isn’t treated promptly. It requires emergency surgery within a matter of hours to prevent death of the trapped tissue. (1) Symptoms of a strangulated hernia may include:
NauseaVomitingFeverSudden abdominal or groin pain that gets worseBulge under the skin that turns red, purple, or darkBulge that grows quickly or hardensInability to pass stool or gas, despite the urge (3,4,5)
If you experience symptoms of a strangulated hernia, it’s crucial to call your doctor right away. You can also call 911 or go to the nearest emergency room. (4) When you arrive at your doctor’s office or at the emergency department with these symptoms, your doctor will give you a physical exam and may order imaging and blood tests. Imaging tests can confirm that you indeed have a strangulated hernia, while blood tests can check for any infection that may have developed as a result. (6) To repair a strangulated hernia, your surgeon will relieve pressure on the trapped tissue and evaluate how damaged it is. If tissue death or severe damage has occurred, it may be necessary to remove the previously trapped tissue — which often means removing part of your intestine. (7) But your risk of developing surgical complications appears to be greater if you’re having an emergency surgery. In a study published in the Journal of the American College of Surgeons, complications developed in 27 percent of people who had an emergency hernia repair, compared with 15 percent of those who had an elective repair. (2) A number of factors may increase your risk of developing complications from hernia repair surgery:
Need for emergency surgeryOlder ageHaving a femoral or scrotal herniaHaving recurrent herniasObesitySmoking (1,2)
Here are some of the most common complications from hernia repair surgery to look out for: Hernia Recurrence Even when a hernia is repaired, it can return — especially if the area undergoes strain while it’s still healing after surgery. (1) Infection While any surgical procedure carries the risk of infection, you’re more likely to develop one if you had a strangulated hernia that resulted in tissue death and decay (necrosis) or an intestinal blockage. (6) You can also develop an infection from the mesh that’s often left inside you to support and repair the weakened area of muscle. (8) Long-Term Pain In some people, pain after a hernia repair surgery — a normal side effect of any abdominal surgery — doesn’t significantly diminish as time goes by. (9) Bladder Injury Both the immediate repair surgery, and the mesh that’s often left in place to repair the weakened area of muscle, can cause damage to your bladder. (10) Intestine Resection Complications If your surgeon needs to remove part of your intestine (known as a resection), this can result in digestive complications. (2) In many cases, complications from a hernia repair require an additional surgery for treatment. (2) Although many people experience unpleasant symptoms from this condition — typically the symptoms of gastroesophageal reflux disease (GERD), in which stomach acid enters the esophagus — this isn’t considered to be a complication. But when the part of the stomach pushing through the diaphragm becomes trapped and strangulated, this is a serious complication that requires surgery. (11)
