Strangulated inguinal hernia

Strangulation of an inguinal hernia most commonly occurs at the external inguinal ring:

• constriction of the hernial neck, or twisting of the hernia, initially obstructs venous return
• oedema eventually obstructs arterial supply
• eventually the bowel necroses and perforates into the hernial sac

Inguinal hernial strangulation occurs most commonly in two age groups:

• most commonly in the elderly
• infants in the first 6 months of life, when up to 25% of inguinal herniae obstruct if untreated

Reference

1. LeBlanc KE et al. Inguinal hernias: diagnosis and management. Am Fam Physician. 2013 Jun 15;87(12):844-8.