usmletaker
Forum Senior
Topics: 33
Posts: 66
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A 36-year-old man presents to his physician complaining of right scrotal swelling. He states that the swelling has been present for 1 week. He
initially noticed the swelling shortly after moving furniture for his new living room. He denies any nausea, vomiting, change in bowel habits,
abdominal pain, or urinary tract symptoms. He has no other significant medical or surgical history. On examination, he has an enlarged right
hemi-scrotum with a mass that appears to be originating at the level of the external inguinal ring. With the patient completely relaxed, the
physician is able to reduce the mass by pushing it back through the external inguinal ring. With the mass reduced, the physician instructs the
patient to perform a Valsalva maneuver, upon which a protrusion is felt at the external inguinal ring. Once the mass is reduced, the testicle
appears normal in size and consistency
Which of the following is the most likely diagnosis?
A. Hydrocele
B. Femoral hernia
C. Inguinal hernia
D. Testicular cancer
E. Varicocele
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| guest
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inguinal hernia
pt should b scheduled for elective surgery.
in case of strangulation. its an emergency
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| no more a loser
Forum Guru
Topics: 140
Posts: 580
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the last post is by me as a 'guest'
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| drjaiswal
Forum Newbie
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Posts: 1
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It is Inguinal Hernia.
Myself Dr jaiswal,graduated from india,24yr,right now in US.
waht about you? 
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| alice8
Forum Guru
Topics: 37
Posts: 643
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direct inguinal hernia
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| Yalguun
Forum Newbie
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This is INDIRECT INGUINAL HERNIA.
If it is direct inguinal hernia it must come out from Hesselbach triangle, and it is not going into the testicle.
ps: This is my first time here and I don't really know about USMLE.I hope that you guys will share your knowledge and experience. Thank you all of your attention.
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| filiz
Forum Newbie
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Posts: 45
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INDIRECT Inguinal hernias almost always result from a persistence of the patent processus vaginalis. Like hydroceles, peritoneal fluid can move into the scrotum, but unlike hydroceles, the processus vaginalis is large enough to allow bowel to herniate into the inguinal canal. The term 'indirect' refers to the fact that the bowel and peritoneal protrusion don't herniate directly through a weakness in the abdominal musculature. Rather, the bowel and peritoneal fluid move through a patent processus vaginalis into the scrotum. Direct inguinal hernias occur because of weakness in the floor of the inguinal canal.
Treatment: Inguinal hernias do not spontaneously resolve so surgery is required. If bowel becomes entrapped within the inguinal canal an incarcerated hernia can occur. This is a surgical emergency because the entrapped bowel can become ischemic
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| filiz
Forum Newbie
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Posts: 45
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soo it C.
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