Strangulation of the intestine is the complication that requires emergency hernia surgery. The primary symptoms of strangulation are severe crampy abdominal pain with nausea and vomiting. It is not subtle and you know that you are sick. These symptoms make it about 98% certian that you need immediate emergency hernia surgery and possible removal of intestine. A less dramatic symptom is your hernia turning red and becoming very painful. For this you must be seen by a physician as soon as possible but the odds are not 100% that it is a strangulation. Untreated strangulation causes death 100% of the time.