When does hernia surgery become an emergency?

Most inguinal hernia repairs are considered elective procedures. However, there is always a chance that a hernia could become strangulated, leading to emergency hernia surgery.

An inguinal hernia occurs when there is a weakness or defect in the abdominal wall that allows the contents of the abdominal cavity to protrude outside. The majority of these hernias can be described as reducible – meaning that can be pushed back in, or returned to the abdominal cavity. Reducible hernias are not life threatening. A very small percentage of hernias cause a situation where emergency hernia surgery is necessary.

When an inguinal hernia is no longer reducible, the abdominal contents – specifically if these including intestine – are permanently stuck outside of the abdominal cavity. This is called an incarcerated hernia. When an incarcerated hernia becomes strangulated, the piece of intestine stuck outside of the abdominal cavity no longer receives adequate blood supply. As the tissues spend longer periods of time with little or no blood supply, they begin to die. This strangulated hernia is a surgical emergency, and you will need to go to the operating room to save the dying tissues.

While this sounds like a very scary end point to an inguinal hernia, emergency hernia surgery is not common. In fact, for asymptomatic inguinal hernias, the risk for becoming strangulated is only 0.1-0.2% per year. Therefore, we typically do not recommend you change your lifestyle just because you have a hernia.

Instead, we would like you to be aware of the risk and what to do if your hernia becomes incarcerated or strangulated.

If you were always able to reduce your hernia, but it has grown enough that you are no longer able to push it back in, it is a good idea to see a surgeon who specializes in hernia surgery to discuss the changes that have occurred.

Another reason to follow up with a hernia trained surgeon is a drastic increase in the pain you are experiencing from your hernia. If this pain is not relieved by the usual methods, then you should be evaluated for an incarcerated or strangulated hernia.

As mentioned above, this is not a common occurrence for inguinal hernias. Less than 1 in 100 hernias we repair are due to emergencies However, emergency surgery for inguinal or umbilical hernia can be serious and sometimes life threatening. If you have symptoms from a hernia it is important to meet with a surgeon who has expertise with hernia surgery in order to schedule elective surgery. You can learn more from our hernia glossary or about the minimally invasive approach we utilize.