In my experience, the sudden development of a large inguinal hernia is more likely to follow an episode where the legs are suddenly stretched apart when the person slips rather than following an episode of lifting.

Inguinal hernias are much more common in men and this is to be expected when we consider the developmental anatomy.

The only proper treatment is operation. Trusses are mentioned only to be condemned. It has been found that long-term results are better if hernias are operated on even in bedridden elderly men.

A common complication of a hernia is that a portion of the bowel in the hernial sac may become trapped, twisted and its blood supply cut off.

If the bowel is just trapped, it is called an incarcerated hernia. If the bowel is kinked and obstructed, it is a strangulated hernia and, when the blood supply is cut off, the bowel becomes gangrenous. These complications usually require urgent operation.

A small hernia with a wide neck which is unlikely to become strangulated may be left if it causes no symptoms. But the tendency is for it to get worse, so operation should not be long delayed.

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