An 88yo woman is a known smoker. She had an attack of MI 2y back
and is known to have peripheral vascular disease. She presents with an
irreducible herniation over the incision region of a surgery which she
underwent in her childhood. What is the most appropriate tx?
a. Truss
b. Elective herniorrhaphy
c. Urgent herniorrhaphy
d. Elective herniotomy
e. Reassure
Answer: C
An irreducible hernia is not strangulated but it is very high risk for impending strangulation and considered an emergency. This woman is of very old age and has significant co-morbidities, she will probably be unfit for general anesthesia, however in such cases a mesh repair can be done under local anesthesia without any problems.
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