Irreducible inguinal or femoral hernia

Medium urgency
-Moderately severe

It is the exit of the intestine out of the abdomen, protruding through an orifice located in the lower abdominal wall. The intestine is trapped but there is no compromise of blood circulation. 

It can be hereditary or acquired, and there are multiple risk factors that cause an increase in intra-abdominal pressure.

It manifests as a painful lump in the lower abdomen, nausea, vomiting, difficulty in passing gas and a hard abdomen. It may also be accompanied by general symptoms: fever, tachycardia and signs of shock.

Diagnosis is clinical by questioning and physical examination revealing an abdominal bulge impossible to reduce through the hernial orifice. A blood test may show signs of infection, renal failure and shock parameters.

It requires urgent surgical treatment, with resection and splicing of a segment of the bowel in most cases. 

Bibliographic references
  1. Fitzgibbons RJ Jr, Ramanan B, Arya S, et al. Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias. Ann Surg 2013; 258:508.
  2. Deeba S, Purkayastha S, Paraskevas P, et al. Laparoscopic approach to incarcerated and strangulated inguinal hernias. JSLS 2009; 13:327.
  3. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet 2003; 362:1561.
  4. Gazmend Krasniqi, Ángel Blanco Bravo. Hernias abdominales en urgencias. Manual de Protocolos y Actuación en Urgencias. 3ª edición (2010). 499:500.
  5. Dabbas N, Adams K, Pearson K, Royle G. Frequency of abdominal wall hernias: is classical teaching out of date? JRSM Short Rep 2011; 2:5.
  6. David C Brooks, Mary Hawn. Classification, clinical features and diagnosis of inguinal and femoral hernias in adults. UpToDate Feb 04, 2016.
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

    Lump in the groin


    Feeling of abdominal heaviness or discomfort


    Groin pain


    Lump is more noticeable when standing up


    Lower left abdominal pain