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Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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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 their 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 between the doctor and patient.



• 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 after giving 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 in which 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 in which the length of time that the hernia was irreducible was short and gangrenous bowel is not suspected, you may be discharged from the hospital.



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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