Causes:
A strangulated hernia may be present from birth or may develop later in life.
The cause of a strangulated hernia, like any other type of hernia, is the weakening of the muscle tissues in the abdominal region, which makes it easier for the tissues from the intestines to push through the muscle tissues.
The abdominal lining may trap the intestines when this occurs, which pinches off some of the organ tissue and leads to strangulation.

Risk factors:
Some factors may increase the risk of developing a strangulated hernia, and may include the following:

1. Pregnancy
2. Straining during bowel movements
3. Strenuous activities, especially when not lifting properly
4. Chronic coughing
5. History of abdominal surgeries or cesarean deliveries

Symptoms:
The symptoms associated with strangulated hernia include:

• Visible bulge in the abdominal or pelvis area
• Sudden pain that becomes severe
• Constipation
• Bloody stools
• Fever
• Fatigue
• Nausea
• Vomiting
• Color changes, tenderness, and inflammation in the skin near the hernia region
• Burning sensation around the hernia
• Inability to pass gas or have a bowel movement 
• Rapid heart rate

1. Physical examination: Strangulated hernias can generally be diagnosed by the doctor by visual inspection and the symptoms described by the patient.
2. Imaging tests: Imaging tests like x-rays, ultrasounds, CT scans, or MRI scans may be taken to check the size of the hernia and if it is causing a bowel obstruction.
3. Blood tests: These tests are performed to check for any underlying medical conditions or illnesses that the patient may be having.
4. Chest x-ray: the condition of the organs in the chest region, that is, the heart and the lungs can be checked by the doctor using a chest x-ray.
5. Electrocardiogram (ECG): The electrical activity of the heart can be recorded using this test to check the heart’s condition before surgery.

Surgery is the only way to treat a strangulated hernia. The surgery should be performed as soon as possible to prevent permanent damage to the affected tissue. Depending on the treatment plan, surgery may be performed under local anesthesia (by numbing the treatment area), or under general anesthesia (by putting the patient to sleep during the procedure). 

Surgery may be performed in the following different ways:

1. Open surgery:
This is the preferred surgery option for a strangulated hernia.
The surgeon will first make an incision or cut in the groin region.
Gentle pressure will then be applied to the hernia to reduce the strangulated hernia by application of pressure to the hernia to help in releasing the trapped tissue back into the abdominal cavity.
The damaged tissue will then be removed if required.
The hernia will be repaired using a tissue or synthetic mesh to prevent any recurrence or future complications.

2. Laparoscopic surgery:
This type of surgery is still being tested for safety while treating strangulated hernia. This is because of the increased risk of injury caused due to this type of surgery.
The procedure is performed by making several small incisions instead of one large incision, as in open surgery.
A laparoscope (a thin tube with a camera on one end) will be inserted through one of the incisions, along with other surgical instruments to repair the hernia.
A synthetic mesh may be used to strengthen the wall of the abdomen.
The incisions are then closed using sutures.

The complications of untreated strangulated hernia may include the following:

1. Gangrene or death of the protruding tissue
2. Shock
3. Sepsis 
4. Intestinal perforation 
5. Death
6. The complications of surgery to treat strangulated hernia may include the following:
7. Bleeding
8. Wound infection
9. Mesh infection 
10. Allergic reaction to anesthesia
11. Difficulty in urinating
12. Nerve damage
13. Pain in the groin or testes region 
14. Constipation 

• The patient will need to stay in the hospital for a few days following open surgery.
• The patient is usually discharged within 24 hours following laparoscopic surgery.
• It is normal to have some pain after surgery. The doctor will prescribe pain-relieving medications to relieve the discomfort.
• Most patients can resume their normal routine within one or two weeks of surgery.
• Follow your doctor’s recommendations about the medications to take and the activities to avoid during the recovery period.

Home remedies:

The following home-care tips can help in providing a rapid and smooth recovery following surgery:

• Keep the surgical area dry and clean for at least 48 hours after surgery.
• Avoid strenuous activities and heavy lifting for a couple of weeks after surgery.
• Eat a fiber-rich, healthy diet.
• Drink lots of fluids to avoid constipation.

Cost of strangulated hernia in India- 

The cost of surgery to treat strangulated hernia in Mumbai is between INR 70,000 to INR 2,50,000.
The cost of surgery to treat strangulated hernia in Delhi is between INR 65,000 to INR 2,25,000.
The cost of surgery to treat strangulated hernia in Bangalore is between INR 65,000 to INR 2,25,000.
The cost of surgery to treat strangulated hernia in Chennai is between INR 60,000 to INR 2,00,000.