Case Report;

Chief Complaint (CC):

45 year old ,M , presented to the clinic with complaints of a bulge in his groin.

History of Present Illness (HPI):

The patient reports noticing a small bulge in his right groin six months ago, which was reducible initially
but has now become more prominent and occasionally painful, especially after lifting heavy objects at
work. He denies any associated symptoms of nausea, vomiting, changes in bowel habits, or urinary
symptoms.

Past Medical History (PMH):

The patient has no significant past medical history. He has never undergone any surgical procedures.

Family History (FH):

There is no significant family history of hernias or other surgical conditions.

Social History (SH):

He is a construction worker and engages in moderate physical activity daily. He smokes approximately
half a pack of cigarettes daily and consumes alcohol occasionally. He denies any illicit drug use.

Physical Examination:

Vital Signs:

- Blood Pressure: 130/80 mmHg

- Heart Rate: 78 bpm

- Respiratory Rate: 16/min

- Temperature: 36.8°C (98.2°F)

- Oxygen Saturation: 98% on room air

General: Alert and oriented, in no acute distress

Abdomen: A reducible bulge is palpated in the right inguinal region, measuring approximately 2 cm in
diameter. No signs of inflammation or skin changes are noted.

Genitourinary: No tenderness on palpation of the testes or scrotum. No evidence of hernias in the left
groin or bilateral femoral regions.

Laboratory Investigations:

- Complete Blood Count (CBC): Within normal limits

- Basic Metabolic Panel (BMP): Within normal limits

- Urinalysis: Negative for blood, protein, and glucose

Differential Diagnosis:

1.Inguinal Hernia:

Mass in right groin, mass bulge prominently after lifting heavy objects.

Management:

1. Surgical Repair
2. Smoking Cessation Counseling prior to surgery.