AbstractThis retrospective study aimed to determine why the incidence of strangulated hernias in adults remains high. Seventy‐nine patients presented with clinical evidence of hernia strangulation which required urgent surgery during the period 1979–87. Forty‐six patients (58 per cent) had noted a hernia present for at least 1 month before strangulation: 18 (23 per cent) had not reported it to their family doctor, 19 (24 per cent) were known by family practitioners or non‐surgical medical personnel to have a hernia but had not been referred for surgical opinion, and nine (11 percent) had been previously assessed surgically with a view to elective repair. Of these nine, five were considered unfit, three were on waiting lists for operation and one had refused surgery. Thirty‐two patients (40 per cent) presented primarily with strangulation within days of developing a hernia. The duration of hernia before strangulation in one patient was unknown. Although an unavoidable number of patients will continue to present with strangulation within days of developing a hernia, the overall incidence could be significantly reduced by greater public awareness of the risks of hernia strangulation and by a policy of immediate patient referral and prompt electi
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