2023-11-24 13:46:42
A hernia is often unnoticeable, especially initially. However, if the intestine is trapped, the symptoms can quickly worsen. What then?
An inguinal hernia (also called an inguinal hernia) occurs at a weak point in the abdominal wall in the groin area: a gap can open there as a hernial opening through which the peritoneal membrane protrudes outwards like a sack. This hernial sac can contain various tissue or organ parts from the abdominal cavity – such as a piece of intestine. The small intestine often forms the contents of the hernia, rarely also the large intestine.
The affected area typically bulges under the skin. The bulge can come and go and cause more or less severe discomfort. Sometimes a hernia doesn’t cause any problems at all. However, this quickly changes when the contents of the hernia – with or without intestines – become trapped in the hernial opening. The first symptoms of such an entrapment (technical term: incarceration) are, for example
a (suddenly) permanently visible and/or larger bulge, reddening of the skin in the area of the hernia and increasing pain or tenderness in the affected area.
Important NOTE
Any trapped inguinal hernia is an emergency – regardless of whether the intestine is trapped or not. If symptoms occur that might indicate entrapment, the following applies: go to the hospital immediately or call the emergency number 112 for help.
If a piece of intestine is trapped in a hernia, further symptoms will soon appear. These can indicate various life-threatening complications that require rapid treatment. These include:
Intestinal obstruction
A constriction of the intestine from the outside can disrupt the further transport of the intestinal contents or bring it to a complete standstill. Such an intestinal obstruction can have different causes. Quite often this is a hernia in which the intestine is trapped. Symptoms of a complete intestinal obstruction include:
severe abdominal pain, nausea and vomiting, bloated stomach, inability to pass stools and pass gas. Vomiting stool
If an intestine that has become trapped in an inguinal hernia has led to an intestinal obstruction, there is a risk that a localized breakthrough through the intestinal wall (intestinal perforation) will occur. This can have various reasons:
On the one hand, liquid and gas accumulate in the intestine above the obstruction, causing the pressure there to increase and the intestine to expand – with the result that the intestinal wall is overstretched and tears more easily. On the other hand, the increased pressure in the intestine can damage blood vessels in the intestinal wall squeeze so that it no longer receives sufficient blood flow – i.e. it also receives too little oxygen – and dies.
Important NOTE
If a piece of intestine is acutely cut off from its blood supply (causing severe abdominal pain), it can die within a few hours.
Peritonitis and sepsis
In the case of an intestinal obstruction with intestinal perforation, a hernia in which the intestine is trapped causes further serious symptoms. Because then intestinal bacteria get into the abdominal cavity, which can lead to peritonitis and/or sepsis.
Incidentally, an incomplete intestinal obstruction (subileus) can be just as serious. The possible cause is an inguinal hernia, in which only a protuberance of the intestine is trapped. The symptoms are often initially weaker than with complete intestinal obstruction. If blood vessels are clamped, the affected tissue can still die – resulting in an intestinal perforation with subsequent peritonitis and/or sepsis.
Peritonitis is typically manifested by a hard abdominal wall. Those affected feel severe pain with any shock and often develop a fever. Sepsis can also be accompanied by fever – and chills. However, some affected people tend to have a low body temperature. Other possible symptoms of sepsis include:
Circulatory shock
Ultimately, progressive circulatory failure can occur if the intestine is trapped in an inguinal hernia. Typical symptoms of such circulatory shock – also simply called shock – are low blood pressure and a racing heart.
Circulatory shock due to an inguinal hernia can have several reasons. For example, if the intestine is so pinched that an intestinal obstruction occurs, the normal absorption of fluid from the intestine is disrupted. Then there is a lack of fluid in the body, which reduces the amount of blood circulating in the circulatory system. Experts refer to this as volume deficiency (hypovolemia). If symptoms of shock occur, this is hypovolemic shock.
However, if an inguinal hernia with intestinal entrapment leads to sepsis, septic shock can result. The various forms of circulatory shock can also occur simultaneously or one following the other. If left untreated, any shock is usually fatal.
Conclusion
It can quickly become life-threatening if the intestine is trapped in a hernia. Anyone who takes the symptoms seriously and seeks medical help immediately is doing exactly the right thing: the sooner appropriate treatment begins in the hospital, the better the chance of survival.
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