Medical Treatment

Treatment of a hernia depends on whether it is reducible or irreducible and possibly strangulated.

• Reducible hernia



• In general, all hernias should be repaired to avoid the possibility of future intestinal strangulation.



• If you have preexisting medical conditions that would make surgery unsafe, your doctor may not repair your hernia but will watch it closely.



• Rarely, your doctor may advise against surgery because of the special condition of your hernia.



• Some hernias have or develop very large openings in the abdominal wall, and closing the opening is complicated because of its large size.



• These kinds of hernias may be treated without surgery, perhaps using abdominal binders.



• Some doctors feel that the hernias with large openings have a very low risk of strangulation.



• The treatment of every hernia is individualized, and a discussion of the risks and benefits of surgical versus nonsurgical management needs to take place.



• Irreducible hernia



• All acutely irreducible hernias need emergency treatment because of the risk of strangulation.



• An attempt to reduce (push back) the hernia will generally be made, often with medicine for pain and muscle relaxation.



• If unsuccessful, emergency surgery is needed.



• If successful, however, treatment depends on the length of the time that the hernia was irreducible.



• If the intestinal contents of the hernia had the blood supply cut off, the development of dead (gangrenous) bowel is possible in as little as six hours.



• In cases where the hernia has been strangulated for an extended time, surgery is performed to check whether the intestinal tissue has died and to repair the hernia.



• In cases where the length of time that the hernia was irreducible was short and gangrenous bowel is not suspected, you may be discharged.



o Because a hernia that was irreducible and is reduced has a dramatically increased risk of doing so again, you should therefore have surgical correction sooner rather than later.

o Occasionally, the long-term irreducible hernia is not a surgical emergency. These hernias, having passed the test of time without signs of strangulation, may be repaired electively.

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