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Strangulation found during repair

Authoring team

Ideally, during the initial assessment of a patient with a femoral hernia, strangulation will be suspected from the history and examination. If this is the case, either of two approaches may be taken to provide adequate access to the sac:

  • extra-peritoneal approach
  • transperitoneal approach

However, strangulation is sometimes found only during low or high approaches, in the absence of convincing clinical features. Evidence for strangulation includes sero-sanguinous fluid within the sac and black bowel seen through the peritoneum.

There are three management possibilities:

  • extraperitoneal approach
  • transperitoneal approach
  • continue with high or low approach

One salient rule is that no non-viable viscus should be returned to the abdominal cavity.


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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