Inguinal Hernia

Gracelle Ann del Rosario

Post-Graduate Intern
Department of Surgery
J.L
30 years old
Male
Admitted on November 14, 2017
Chief Complaint

Scrotal Mass
History of Present Illness

2 months prior to admission,

(+) Bulging scrotal mass, right,
Reduced manually
Aggravated by lifting heavy objects and
coughing
Occasional inguinal pain
No associated abdominal pain, abdominal
distention, vomiting
History of Present Illness

One week prior to admission

Persistence of scrotal mass, prompted consult
and was subsequently admitted
Past Medical History

no HPN
no DM
no Asthma
no previous surgery and accident
no previous hospitalization
Family Medical History

(-) HPN
(-) DM
(-) PTB
(-) Malignancy
(-) Asthma
(-) Goiter
Personal and Social History

Construction worker
Smoker (1.5 pack year)
Occasional alcoholic drinker
(-) Illicit drug user
Physical Examination

General Survey: Patient is conscious, coherent, not in cardiorespiratory

distress
Vital signs: BP: 110/70 PR: 86 RR: 20 Temp: 36.9C O2 Sat: 98%
Skin: Moist, good skin turgor, good capillary refill time of less than 2 secs
HEENT: Anicteric Sclerae, pink palpebral conjunctiva, no naso-aural
discharge, no cervical lymphadenopathy, no neck mass
Chest / Lungs: Symmetrical chest expansion, no retractions and lagging,
clear breath sounds
Heart: Adynamic precordium, PMI at 5th intercostal space, left
midclavicular line, normal rate, regular rhythm, no murmur
Physical Examination

Abdomen: Flabby, normoactive bowel sounds, soft, non-tender

upon light and deep palpation, no hepatosplenomegaly
(+) right scrotal mass, non-tender, non-erythematous
(-) transillumination test
Inguinal occlusion test: touches tip of the index finger upon
coughing.
Physical Examination

Extremities: Grossly normal extremities, no cyanosis, no edema, full

and equal pulses
Impression

Indirect Inguinal Hernia, Right

Differential Diagnosis
Differential Diagnosis

Varicocele
Hydrocele
Diagnostics and Laboratories

Ultrasound
Discussion:

INGUINAL HERNIA