A 50-year-old patient miraculously survived after ten days of excruciating pain from a strangulated hernia that led to the development of generalized septicemia. The case was reported by the surgeon Constantin Truș.
“At the very beginning of 2026, being on call, I was called to the Emergency Department for a case of strangulated hernia. Nothing special so far, but from the first palpation I felt the rigidity of the patient’s abdomen, an aspect that usually indicates a critical condition. I asked the patient how long he had been in that condition. I was not a little surprised when he told me that he had been like this since Christmas, ten days to be exact”, said Constantin Truș, surgeon at the Galati County Hospital.
The doctor Constantin Truș noticed that the intestine was necrotic, and the contents had overflowed into the abdominal cavity, where it had caused a massive infection
“Clearly the bowel was necrotic and the contents had spilled into the abdominal cavity, where it had caused a massive infection. I looked in amazement at the 50-year-old patient, conscious and coherent, talking to me about the evils of vice while holding his stomach with one hand…it was a miracle he was still alive. (…) The strangulated hernia you have, however, is putting you at risk and we must deal with it, I told him to the patient(…) If we don’t quickly remove the necrotic piece of intestine, the infection, already extensive, will make things worse… much worse”, said the doctor Constantin Truș.
“A Nightmare Peritonitis”
The patient underwent emergency surgery, and the intervention revealed severe peritonitis: the piece of intestine caught in the hernia was necrotic, and the viable ends communicated directly with the abdominal cavity. The operation, which was initially estimated at 30 minutes, lasted two hours.
“I started the operation already knowing what to expect: strangulated hernia, trapped piece of necrotic intestine and leakage of jejunal fluid into the abdominal cavity. The predicted operation time was 30 minutes, but on the spot, take the necrotic piece of intestine from where it is no longer … it was decomposed, and the viable ends of the intestine communicated directly with the abdomen. A nightmare peritonitis”, said Dr. Trus.
After the first intervention, the patient started to recover, but five days after the operation, he had another infection in the blood.
“Day six: incipient fistula and pus in the surgical area. I intervened promptly and removed any trace of re-infected tissue, redid the suture…only now, after removing everything that could cause septicemia, the count started again. One day without infection, two days without infection, three days…”, the doctor also said.
Doctor Truș emphasizes the danger of ignoring the symptoms of hernias.
“What would the situation have been like if the patient had come to the hospital on time and not waited ten days with a strangulated hernia? Now he would be home, safe and sound, not at the border. Ignorance, fear, embarrassment – maybe all in one.” the surgeon relayed.
“I sit and think as I write these lines: what would the situation have been like if the patient had come to the hospital on time and not waited for ten days with a strangulated hernia? Now he would be at home, well and healthy, not at the border. Ignorance, fear, embarrassment, what were the reasons that made him stay at home for so long in pain … maybe all together?”, the surgeon relayed.
When a seemingly minor problem can become a medical emergency
Doctor Constantin Ttruș recommends that any hernia be consulted and treated promptly, because it does not heal by itself, and the complications can be extremely serious.
“An inguinal hernia occurs when part of the abdominal contents, usually fat or a loop of intestine, protrudes through a weak point in the abdominal wall. It is not just a visible bulge, but a clear signal that the integrity of the wall has been compromised”explains Dr. Constantin Truș.
In many cases, inguinal hernia begins without intense pain, which is why many patients postpone medical consultation.
Among the most common symptoms are the appearance of a swelling in the groin area, more visible with exertion, coughing or prolonged standing and which may disappear when lying down, the sensation of local pressure or burning, accentuated towards the end of the day, and dull pain, sometimes radiating to the scrotum in the case of men or along the lower limb.
The real danger arises when the hernia becomes complicated by strangulation.
“If the portion of intestine becomes blocked and cannot be reinserted into the abdomen, blood circulation is cut off. A simple, scheduled surgery can suddenly turn into a major emergency.” warns the specialist.
Inguinal hernia treatment is exclusively surgical.
“Today, hernia repair no longer just means
The doctor points out that the inguinal hernia does not heal by itself. Without treatment, it tends to grow and become more complicated. The specialists’ recommendations are clear: the appearance of swelling or persistent discomfort should not be ignored, intense physical exertion should be avoided until surgical evaluation, and a scheduled operation is always safer than emergency intervention.
The first steps are simple: consultation with the family doctor and referral to a surgeon. “It’s better to deal with these problems while they are small and uncomplicated and let the on-call cameras deal with the real emergencies,” concludes Dr. Constantin Truș.
