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Diagnosis of Incarcerated Versus Strangulated Hernias

When the patient or emergency care provider cannot manually reduce the contents of the hernia back into the abdominal cavity, the hernia is described as incarcerated. A patient with an incarcerated hernia often presents with a mass that is painful, discolored, enlarged, and not reducible. Associated symptoms may include nausea, vomiting, fever, scrotal pain, labial pain, or abdominal distention. Patients with incarcerated hernias do not necessarily have associated bowel obstruction, and those with a bowel obstruction are not necessarily incarcerated. Incarceration is more common with femoral hernias, small indirect inguinal hernias, and abdominal wall hernias.[25] They can be caused by the presence of a small fascial defect, by constriction of the defect by outside musculature, or by swelling of the hernia contents.

A strangulated hernia is an incarcerated hernia in which the vascular supply to the herniated bowel is compromised, thus …