Strangulated hernia (emergency surgery)

A hernia is said to be strangulated when its contents (in the groin, at the navel or in an incisional hernia) become stuck in the opening and can no longer go back into the abdomen. The bulge becomes hard, very painful, sometimes red, and is often accompanied by nausea, vomiting and an inability to pass wind or stools. The trapped bowel is deprived of blood: this is a surgical emergency. The operation aims to free the bowel, check that it is still healthy and then repair the opening. If the loop of bowel has been irreversibly damaged, the surgeon removes the damaged segment (bowel resection) and joins the two ends. The wall repair is adapted to the situation: a mesh may be placed if conditions allow, otherwise a stitched repair is preferred. Any hernia that suddenly becomes hard, painful and will not go back in requires an immediate visit to the emergency department. The faster the operation, the better the chances of saving the bowel. At Clinique Pasteur Tunis, the emergency department is open around the clock and operating theatres are available day and night, with an intensive care unit if the patient's condition requires it.