Treatment of incarcerated hernia in adults.

Of the 14,000 hernias operated annually in Finland, approximately 5 to 6% are treated as emergencies usually due to incarceration. Compared with elective hernia operations, emergency operations carry an increased risk of complications and death, especially in elderly patients and those with comorbidities. The risk of hernia recurrence is higher after an emergency procedure. In an emergency situation, a solution resulting in the best immediate and long-term outcome should be selected for each patient. Sometimes it is best to treat only the acute incarceration, whereas in some cases a hernia repair with good and lasting outcome can be safely performed already during the acute situation. Besides the nature of the hernia itself, the decisions are affected by the general condition and underlying disease of the patient, as well as the surgeon's experience. Emergency hernia surgery requires experience, as suboptimal solutions will complicate any repair operations that may be required later.