Hernia Hernia Complications and Emergencies 1 — Questions and Answers
Question 1: What is the most feared acute complication of a hernia?
- Seroma
- Strangulation (Correct answer)
- Recurrence
- Mesh rejection
Correct answer: Strangulation
Strangulation—compromise of the blood supply to the herniated organ—is the most dangerous complication, leading to ischemia, necrosis, and sepsis.
Question 2: What percentage of untreated femoral hernias are said to be at high risk of strangulation compared to inguinal hernias?
- Femoral hernias have a lower strangulation risk than inguinal
- Femoral hernias have a much higher strangulation risk (up to 40%) than inguinal (Correct answer)
- Both have equal strangulation risk
- Strangulation occurs only in umbilical hernias
Correct answer: Femoral hernias have a much higher strangulation risk (up to 40%) than inguinal
Femoral hernias have a significantly higher strangulation rate (approximately 40%) compared to inguinal hernias because the femoral ring is narrower and rigid.
Question 3: What surgical procedure is performed when strangulated bowel is found to be non-viable at hernia repair?
- Simple reduction of the bowel
- Bowel resection with anastomosis (Correct answer)
- Placement of biologic mesh only
- Closure of the defect without bowel handling
Correct answer: Bowel resection with anastomosis
Non-viable (necrotic) bowel must be resected and the two healthy ends reconnected (anastomosis) to restore bowel continuity.
Question 4: Incarceration differs from strangulation in that incarceration indicates what?
- The hernia is reducing spontaneously
- The hernia contents are trapped but blood supply is still intact (Correct answer)
- The hernia contains only fat, not bowel
- The hernia has perforated
Correct answer: The hernia contents are trapped but blood supply is still intact
Incarceration means the hernia cannot be reduced but does not necessarily imply vascular compromise, whereas strangulation additionally means blood supply is cut off.
Question 5: Which post-operative hernia complication presents with fever, wound erythema, and purulent discharge?
- Seroma
- Hematoma
- Wound infection (Correct answer)
- Hernia recurrence
Correct answer: Wound infection
Wound infection after hernia repair presents with the classic signs of inflammation (fever, redness, warmth) and purulent drainage from the incision.
Question 6: What is the most common long-term complication of hernia repair?
- Mesh infection
- Hernia recurrence (Correct answer)
- Bowel obstruction from adhesions
- Testicular atrophy
Correct answer: Hernia recurrence
Hernia recurrence remains the most common long-term complication, occurring in 1–5% of mesh repairs and up to 15% of tissue-only repairs.
Hernia Hernia Complications and Emergencies 1
What is the most feared acute complication of a hernia?