Name of the Condition

• Incisional Hernia with Gangrene
• Technical Term: Intestinal ischemia due to hernia (K43.1)

Summary

Incisional hernia with gangrene occurs when tissue protrudes through a surgical scar in the abdominal wall, leading to compromised blood supply and eventual tissue necrosis.

Causes

• Previous abdominal surgery resulting in weakness at the incision site
• Increased abdominal pressure from activities like heavy lifting or persistent coughing
• Insufficient healing post-surgery

Risk Factors

• History of abdominal surgeries
• Obesity
• Advanced age
• Poor nutrition or certain chronic conditions affecting healing (e.g., diabetes)

Symptoms

• Visible bulge or protrusion near a surgical scar
• Severe abdominal pain
• Skin discoloration over the hernia site (indicative of gangrene)
• Nausea and vomiting

Diagnosis

• Physical examination to identify hernia
• Imaging tests such as ultrasound or CT scan to assess gangrene

Treatment Options

• Emergency Surgery: To remove necrotic tissue and repair the hernia. Vital for restoring blood flow.
• Antibiotics: To manage or prevent infection.
• Supportive Care: To stabilize patient's condition before and after surgery.

Prognosis and Follow-Up

• Prognosis depends on timely surgical intervention.
• Regular follow-ups are essential to monitor healing and prevent recurrence.

Complications

• Severe infection (sepsis) from untreated gangrene
• Intestinal blockage or perforation
• Recurrent hernias

Lifestyle & Prevention

• Maintain healthy weight through balanced diet and regular exercise
• Avoid heavy lifting and strenuous activities post-surgery
• Follow post-operative care instructions thoroughly

When to Seek Professional Help

• Sudden, intense abdominal pain
• Changes in the color of the bulge
• Symptoms of infection like fever or chills

Additional Resources

• American Hernia Society: herniasociety.org
• National Institute of Diabetes and Digestive and Kidney Diseases: niddk.nih.gov

Tips for Medical Coders

• Ensure documentation specifies gangrene with the hernia for accurate coding as K43.1.
• Avoid confusing with simple incisional hernia code (K43.2).