Inguinal and femoral hernias

What you need to knowAsk patients about associated symptoms, such as fever, nausea, or change in stooling to help identify whether their hernia is obstructed or strangulatedIf a hernia is suspected on examination, there is no routine requirement to differentiate whether it is direct or indirect, or to request further imaging, before referralRefer suspected femoral hernias for routine or urgent surgical evaluation; refer painful, newly irreducible hernias or hernias with skin colour changes for urgent surgical assessmentAn 82 year old man with a background of hypertension, ischaemic heart disease, gout, and previous prostatectomy presents with a right sided lump in the groin. This has been present for several months but has become increasingly painful. On examination, there is a soft, non-tender 5 cm lump in the groin extending towards the scrotum. There are no skin changes, and, although there is a cough impulse, it does not fully reduce on lying…
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