A 70-year-old woman with chronic constipation presents to the Emergency Room with abdominal distension and vomiting. Examination revealed an abdomen that is distended and tympanic,... A 70-year-old woman with chronic constipation presents to the Emergency Room with abdominal distension and vomiting. Examination revealed an abdomen that is distended and tympanic, with a round tender non-reducible swelling in the right groin below and lateral to the pubic tubercle. X-ray of the abdomen shows distended small bowel with multiple fluid levels. Which of the following is the most likely diagnosis? A. Femoral hernia B. Direct inguinal hernia C. Metastatic lymphnode D. Indirect inguinal hernia
Understand the Problem
The question describes a clinical scenario of a 70-year-old female presenting with symptoms and physical exam findings suggestive of a bowel obstruction. The key finding is a tender, non-reducible swelling in the right groin below and lateral to the pubic tubercle, along with X-ray findings of distended small bowel. The question asks for the most likely diagnosis among the given options.
Answer
The most likely diagnosis is a femoral hernia.
The most likely diagnosis is a femoral hernia. The presentation of a 70-year-old woman with chronic constipation, abdominal distension, vomiting, and a non-reducible swelling in the right groin below and lateral to the pubic tubercle, along with X-ray findings of small bowel obstruction, strongly suggests a femoral hernia.
Answer for screen readers
The most likely diagnosis is a femoral hernia. The presentation of a 70-year-old woman with chronic constipation, abdominal distension, vomiting, and a non-reducible swelling in the right groin below and lateral to the pubic tubercle, along with X-ray findings of small bowel obstruction, strongly suggests a femoral hernia.
More Information
Femoral hernias are more common in women and tend to present with incarceration or strangulation due to the narrow neck of the femoral canal. The symptoms described are consistent with bowel obstruction secondary to hernia incarceration.
Tips
A common mistake is confusing the different types of groin hernias. Remember that femoral hernias are located below the inguinal ligament and lateral to the pubic tubercle, whereas inguinal hernias are above the inguinal ligament.
Sources
- Question Sets and Answers - PMC - PubMed Central - pmc.ncbi.nlm.nih.gov
- Solved 6. A 70-year-old male patient is experiencing | Chegg.com - chegg.com
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