All incarcerated or strangulated hernias demand admission and immediate surgical evaluation. For umbilical hernias, the patient may be discharged with close follow-up care if the defect is less than 2.0 cm in diameter and the hernia is not incarcerated or strangulated. Educate patients to avoid those activities that increase intraabdominal pressure. Counsel avoidance of activities that increase intraabdominal pressure, such as straining at stool or lifting heavy objects. If strangulation of the hernia is missed, bowel perforation and peritonitis can occur.
Hernias can reappear in the same location, even after surgical repair.
Prognosis is good with timely diagnosis and repair. Apply support to the hernia. Even with asymptomatic hernias, early repair is better before it enlarges. Pain after reduction of a hernia may indicate a strangulated hernia requiring further evaluation by a surgeon. Chronic inguinal hernia.