Signs and symptoms of hernia may vary. It could be mild where one presents with a swelling which is usually not painful, appears during standing or coughing or straining and dissappears when lying down or pushed back with hand. Other may present with severe features like painful swelling to some extent cannot be touched, hence cannot be pushed back into the abdomen or irreducible, skin may look red or blackish and patient may develop fever. This is due to hernia contents such as intestine has received reduced blood supply as its blood vessels may be compressed usually at the hernia opening. This is called srangulated hernia.
•Reducible hernia
◦It can appear as a new swelling at the groin or at other abdominal area.
◦One may feel mild dull pain but usually touching the swelling will not cause pain.
◦Swelling will appear or increase in size when standing or when there is increase in the abdominal pressure (eg. coughing).
◦It can be pushed back into the abdomen (reducible).
•Irreducible hernia
◦It appears as a swelling which may be mildly painful, initially able to appear and dissappear (reducible), later on it can go into abdomen by itself or be pushed into by hand.
◦Some may become chronic when the swelling is not reducible for quite sometime especially if it is not painful, the patient does not bother to seek treatment.
◦It may worsen and become strangulated hernia.
•Strangulated hernia
◦Commonly begins as an irreducible hernia then later got obstructed and strangulated at the hernia opening causing compression to the blood vessels, eventually will compromise the blood supply to the intestine in the hernia sac.
◦Usually patient will have severe pain when swelling is touched or pressed. There will be signs and symptoms of intestinal obstruction (such as nausea, vomiting and abdominal distension).
◦Patient may develop fever and looked very ill.
◦This condition is an emergency/surgical emergency. Urgent surgery has to be done.
