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November 23, 1935


JAMA. 1935;105(21):1675-1677. doi:10.1001/jama.1935.02760470029008

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An unusual and dangerous complication of hernias is reduction en masse. This condition nearly always creates an emergency, since false reduction almost inevitably causes strangulation of the hernial contents. The gravity of such a situation makes it necessary to consider the possibility of hernia reduced en masse whenever certain characteristic clinical features are present.

This condition was recognized as early as 1702, when Saviard1 first noted its occurrence. Conner and Howitt2 in 1908 collected five instances in 1,618 cases of strangulated hernia at the St. Thomas and St. Bartholomew hospitals. Pearse3 in 1931 published a statistical study based on 193 cases collected from the literature. Force and taxis appear to be the precipitating factors in 93 per cent of the cases. It occurs more commonly in males than in females, usually on the right side, and in inguinal rather than in femoral hernias. Pearse found only 12

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