How can one distinguish between an incarcerated and strangulated hernia?

The distinction between an incarcerated and strangulated hernia is critical for proper management. In the case of a strangulated hernia, the blood supply to the entrapped tissue is compromised, which can lead to necrosis. This condition often presents with systemic signs of infection or inflammation such as fever, chills, and leukocytosis. These systemic findings occur due to the body's response to the ischemic tissue dying and potentially leading to peritonitis if not addressed promptly.

In contrast, an incarcerated hernia may not necessarily produce these systemic signs because the blood supply is typically still intact, even though the tissue is trapped. Thus, the absence of systemic symptoms such as fever and leukocytosis is a key feature of an incarcerated hernia.

By observing these systemic findings in conjunction with the patient's clinical presentation, healthcare providers can differentiate between the two conditions. In this context, the presence of fever, chills, and leukocytosis strongly indicates a strangulated hernia requiring immediate intervention.