A strangulated hernia is an acute form of intestinal obstruction which exhibits, in addition to the usual symptoms, certain local signs. The results of the strangulation are a sudden and severe irritation of the abdominal plexus of sympathetic nerves, an interference with the return flow of blood, an obstruction to the fecal current and local injury.
The irritation of the peritoneal and intestinal nerves causes reflex vasomotor changes which account for the extreme prostration, the rapid, feeble, low-tension pulse, the shallow respiration, the subnormal temperature, the cold and livid extremities, the cold sweats, the diminished amount of urine, and partly for the vomiting, constipation and pain.
Interference with the venous current accounts for the local signs, which are tension, irreducibility, pain, tenderness, dulness on percussion and absence of impulse.
Obstruction to the fecal current accounts for the constipation, vomiting, tympanites and the presence of indican in the urine.
ROTH H. DIAGNOSIS OF STRANGULATED HERNIA. JAMA. 1900;XXXIV(6):321–322. doi:10.1001/jama.1900.24610060003001b
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