Title Groin swelling ✅

GROIN SWELLING GROIN SWELLING Hx PE Inguinal Hernia INDIRECT - Male, young - dt congenital PPV DIRECT - > in elderly - RF : Inc intra-abd pressure Neck lateral to inferior epigastric artery out of Hesselbach’s Triangle Neck lies medial to inferior epigastric artery within Hesselbach Reduces upwards, laterally, backwards Reduce upwards, straight backwards Controlled after reduction by pressure over deep ring Controlled after reduction over superficial ring Izzaty, Nisa, Iman, Lissa (7/6/2021) Forti
Femoral Hernia - > in women - > to incarcerated/ strangulation→ emergency OT - Site: Medial to femoral pulse, inferior and lateral to pubic tubercle via femoral canal - usually not reducible - no cough impulse - Incarcerated→ tender firm mass Inguinal Lymphaden opathy - Infections of the leg or foot, STDs (e.g., herpes simplex virus, gonococcal infection) - Lymphoma, pelvic malignancy, - non-tender swelling + rubbery + limited movement + cystic quality on palpation - SIte: outside inguinal canal + x extend to scrotum Saphena varix - RF: prolonged standing, smoking, prior venous thrombosis, lower extremity trauma, fam hx venous dx - Non-tender - Has cough impulse - Thrills upon palpation when coughing + inspection of the limb in a standing position Femoral artery aneurysm - older pts, male - RF: smoking, HPT, HL, CAD, PAD, vasculitis, CTD - pulsatile asx mass - pain over the mass from compression of femoral n. - any acute limb ischemia Lymphoma - Fever + night sweats + LOW - RF: immunodeficiency, fam hx - Painless, rubbery, firm - may increase in size - organomegaly - cervical, supraclavicular, axillary lymphadenopathy Undescend ed testes - > in children - RF: prematurity, LBW, SGA - > in left sided, may bilateral - empty scrotum Groin abscess -IVDU who inject into the groin -Hidradenitis suppurativa (affect hair follicles) ● painful, ● tender ● indurated ● erythematous ● firm → the overlying skin becomes thin and fluctuant Izzaty, Nisa, Iman, Lissa (7/6/2021) Forti
More common in pregnancy → femoral & umbilical hernia Causes of hernia → smoking, copd, peritoneal dialysis, pregnancy, obesity INGUINAL HERNIA Defect/weakness in abdominal wall causing abnormal protrusion of intraabdominal contents - M>F 9:1 - Reducible hernia: contents can return into position - Irreducible: contents cant return due to adhesion btwn contents Anatomy Izzaty, Nisa, Iman, Lissa (7/6/2021) Forti
Aetiology 1. Anatomical → Weakness due to structures entering & leaving the abdomen 2. Acquired → Sharp/blunt traumas, ↑ intra-abdominal pressure 3. Congenital → Failure of processus vaginalis to close 4. Physiological → Weakness due to ageing and pregnancy Izzaty, Nisa, Iman, Lissa (7/6/2021) Forti