Management

• Complicated inguinal hernias

  • Strangulated hernia and/or signs of mechanical bowel obstruction: emergency surgery (within hours)

  • Incarcerated hernia without strangulation: Consider manual reduction of the inguinal hernia.

    • Successful manual reduction: Close monitoring is required; consider surgery during the same hospital admission.

    • Unsuccessful manual reduction: urgent surgery

• Uncomplicated inguinal hernia: Recommend elective surgery; consider watchful waiting in selected patients.

• Consider NG tube insertion for obstructed hernias.

• Description: A bedside procedure where hernia contents are manually guided back into the abdominal cavity through the fascial inguinal defect.

• Indication: Consider as a temporizing measure before surgery in patients with an incarcerated hernia with or without bowel obstruction.

• Contraindication: strangulated inguinal hernia

Manual reduction of hernial contents is contraindicated in patients with signs of a strangulated hernia, as necrotic bowel or omentum may be pushed into the abdominal cavity, which can lead to serious complications including peritonitis.