It is the protrusion of a segment of intestine from the abdomen. It is called strangulated if the intestine cannot be returned to the abdomen and its internal structure is damaged.
There are hereditary causes (congenital abdominal wall disease) and acquired causes (abdominal trauma). Its appearance is favoured by obesity, intense physical activity and chronic constipation.
It manifests as a painful lump in the abdominal wall. The pain usually increases with standing, straining to pass stools and coughing. It may be accompanied by nausea, vomiting, loss of appetite, low-grade fever and increased abdominal girth. In the most severe cases, there is severe abdominal pain leading to a hardening of the abdominal wall.
The diagnosis is made clinically by questioning and physical examination, which will reveal a painful lump that cannot be passed back into the abdomen. Imaging tests may be needed to confirm the diagnosis: X-ray, abdominal ultrasound and/or CT-scan.
It requires urgent surgical treatment, often involving the resection of a bowel segment.
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