Groin Lump Flashcards
What anatomy can be helpful to determine differential diagnosis for going lump?
- Psoas sheath
- Femoral nerve
- Femoral artery
- Femoral vein/long saphenous vein
- Lymph nodes
- Hernial orifices
- Skin/subcutis
What differential diagnosis for going lump are related to the psoas sheath?
- Psoas abscess
2. Psoas bursa
What differential diagnosis for going lump are related to the femoral nerve?
neuroma
What differential diagnosis for going lump are related to the femoral artery?
- femoral aneurysm
2. psuedoaneurysm
What differential diagnosis for going lump are related to the femoral vein/ long saphenous vein?
saphena varix (dilated great saphenous vein due to incompetence at the saphenofemoral junction)
What differential diagnosis for going lump are related to the lymph nodes?
lymphadenopathy (infectious or malignant)
What differential diagnosis for going lump are related to the hernial orifces?
- ectopic testis
- undescended testis
- hydrocele of cord
What differential diagnosis for going lump are related to the skin/subcutis?
- lipoma
- infected abscess (e.g. from IV drug use)
- sebaceous cyst
What are the common reasons for going lump in order of prevelance?
- Indirect inguinal hernia
- Direct inguinal hernia
- Femoral hernia
- Saphena varix
- Psoas abcess/bursa
- Lipoma
- Sebaceous cyst
- Neuroma
- Femoral aneurysm/pseudoaneurysm
- Ectopic testis
- Undescended testis
- Hydrocele of cord
What questions do you ask about the groin lump?
- How long has the lump been there
- Is the lump always there? does it reduce when patient lies down?
- Has lump got bigger or smaller or stayed the same
- Is lump painful
- Any other lump?
When would a femoral arterty pseudoaneurysm show up?
after angiography
When would a direct inguinal hernia show up?
period of heavy lifting
When might inguinal lyphadenopathy show up?
lower limb infection
When would ectopic + undescended testis present? How is it fixed?
present from birth + fixed by orchidopexy and orchidectomy
Why do you ask if the lump was always there or if it reduces when patient lies down?
hernias and saphena varix
What can increase hernia size?
coughing and straining stool
How does the size of a saphena varix change?
increase if stand long time but disappears as soon as patient lies down
Do most lumps change in size over time?
yes
What would a rapid change in groin lump size suggest?
infective process e.g. psoas abscess, or lympahdeopathy
Are reducible and incarcerated hernias painful?
can be or not