Inguinal Hernia

HISTORY:

Bulging on ‍rightleft ‍groinabdominal wall for ‍ ‍hoursdays

Onset: ‍gradualsudden, following ‍ ‍strainingliftingcoughingexercise

Type: ‍painfulpainless, ‍reduciblenon-reducible, ‍changedunchanged in size

Worsening factors: ‍none

Alleviating factors: ‍nonemanual reduction, ‍effectiveineffective

‍swelling around the bulge

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍

‍fever, up to ‍°, over ‍ ‍hoursdays

‍changes in bowel habits

‍constipation

‍diarrhea, ‍ episodes ‍per day, ‍

‍abdominal distension

‍abdominal pain, ‍diffuse, ‍dull, ‍mild

‍discoloration of the bulge area

‍urinary symptoms



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Pelvic: vulva ‍normal, vagina ‍normal, cervix ‍normal, uterus ‍normal, adnexa ‍normal, ‍no cervical motion tenderness

Genital: ‍normal, testicles ‍normal, penis ‍normal



ASSESSMENT:

‍Inguinal Hernia ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Abdominal ultrasound

- CT scan of the abdomen

- ‍Analgesics

- ‍Stool softeners

- Hernia truss

- Avoid strenuous activities such as heavy lifting, vigorous exercise, and straining during bowel movements

- Referral to general surgeon

- Follow-up in ‍ ‍weeksmonths

- Return if pain becomes persistent, if new symptoms develop such as vomiting or fever

- Go to the ER if severe pain, persistent vomiting, or signs of strangulation such as skin discoloration over the hernia