Groin lump Flashcards
Most common causes of groin lump
Indirect inguinal hernia Direct inguinal hernia Femoral hernia Inguinal lymphadenopathy Saphena varix Psoas abscess Femoral aneurysm Cyst Lipoma Neuroma Testis related
What anatomy is in the groin?
Psoas Femoral artery Femoral vein Long saphenous vein Lymph nodes Testicular apparatus Skin Hernial orifices!
What groin lump may be a differential with recent angiography?
Femoral artery pseudoaneurysm (collection of blood outside the vessel lumen)
The lump gets bigger when the patient stands up for an extended period of time =>
Saphena varix
What should you ask the patient to do to check for hernias?
Cough
Complications of hernias
Strangulation
Bowel obstruction
RF for hernias
Constipation and straining
Heavy lifting
ABDOMINAL SURGERY
How do you distinguish between a hernia and saphena varix?
Saphena varix will disappear when lying down
Worse on standing
Hernia protrudes when coughing
How do you tell between an inguinal and femoral hernia?
Femoral hernias are below the pubic tubercle
Appropriate management of inguinal hernia
Elective surgery
Causes of inguinal lymphadenopathy
Local infection
HIV
Lymphoma
Do a FBC!
Consider FNA for histology (maybe lymphoma yeah see)
What does the inguinal canal contain in men?
Ilioinguinal nerve
Spermatic cord
What does the inguinal canal contain in women?
Ilioinguinal nerve
Round ligament
What are the boundaries of Hesselbach’s triangle?
Medial = rectus sheath Inferiorly = inguinal ligament Superiorly = deep inferior epigastric artery
Complications of surgical hernia repair
Normal = haemorrhage, infection, DVT, anaesthetic complications
Hernia specific = recurrence, bruising of scrotum and penis, ischaemic orchiditis
