Incarcerated and Strangulated Hernia

A patient presenting with an acutely incarcerated hernia is a common consultation in general surgery. This algorithm provides an evidence-based approach for the management and (when needed) acute operative repair for incarcerated hernias. However, bedside reduction can be attempted for early presentation without skin changes and biochemical abnormalities. When successful, close clinical observation is necessary to ensure the underlying herniated bowel was not compromised. If bedside reduction is unsuccessful or not possible, this algorithm will help to identify the optimal approach for both incarcerated ventral and inguinal hernias.