Abstract
Inguinal hernia is a very common clinical condition, and its incidence is higher in elderly patients. Different factors are involved in the etiology of the disease, either congenital or acquired. Most inguinal hernias are asymptomatic but may develop complications such as incarceration. Diagnosis, in uncomplicated cases, is easy and based on physical examination. Imaging studies are helpful when the diagnosis is unclear, especially if bowel strangulation is suspected. Elective surgical hernia repair is considered the treatment of choice. However, in elderly patients with a high surgical risk, a watchful-waiting approach is advisable. The choice of surgical technique depends on the experience of the surgeon and the contamination of the surgical field. The classical approach is Lichtenstein open tension-free mesh repair, although laparoscopy has been proposed. The use of mesh in incarcerated inguinal hernia is disputed because of the increased risk of postoperative wound infection. General anesthesia is usually preferred in particular if bowel ischemia is suspected and intestinal resection may be required. However, local anesthesia is expanding its indication since it provides effective anesthesia with less postoperative complications.