OBIORA-EZE DIKE IM-535 04/08/2021

Passport Data
Age:- 69 year old
Sex:- Male

Complaints
● Cramp like abdominal pain
● nausea

History
● Patient is admitted to the hospital with complaints in the
right inguinal area which started about a month ago.
● He complained of cramp like abdominal pain and nausea.
● Bowel movements were normal and he didn’t have any fever
● He is married with 4 children
● He’s a retired man and has middle class socio-economic
status.
● He’s non-vegetarian. He loves to eat meat and fried food.
● No significant past surgical history.

Objective Examination
● He is moderately built
● Maintains an erect posture and steady gait
● Groin:- 3x4cm right inguinal swelling that is reducible and
non-tender on palpation associated with scrotal swelling.
● Redness of skin is absent
● Temperature:- 36.5*C
● BP:- 138/84mmHg
● Pulse is 82bpm
● Respiration rate:- 24bpm
● O2 saturation:- 99%(room air)
● Height:- 156cm Weight:- 68kg BMI:- 24

Plan of Investigation
● CBC
● Biochemical Blood Analysis
● Abdominal Ultrasound
 ● Abdominal x-ray

Lab Results
●
Description Value Range

WBC 8.4x10*3ul 3.6-11

RBC 4.84x10*6ul 4.5-6

Platelet 231x10*3ul 150-400

Creatinine 1mg/dl 0.7-1.2

Urea 22mg/dl 12-40

Potassium 4.7mmol/l 3.3-4.8

Sodium 138mmol/l 136-145

Chloride 112mmol/l 98-108

HIV Negative

HbsAg Negative

Diagnosis
Right-sided pinched Inguinal Hernia

Treatment
● Open Hernia Repair:- In this procedure, which might be done
with local anesthesia and sedation or general anesthesia,
the surgeon makes an incision in your groin and pushes the
protruding tissue back into your abdomen. The surgeon then
sews the weakened area, often reinforcing it with a
synthetic mesh (hernioplasty). The opening is then closed
with stitches, staples or surgical glue. After the surgery,
you'll be encouraged to move about as soon as possible, but
it might be several weeks before you're able to resume
normal activities.
● Tab Zinnat 500mg 5 days
 ● Tab. Paracetamol 1g

Recommendations
● Avoid heavy lifting and strenuous exercises for 6-8 weeks
● Maintain personal hygiene
● Continue with oral antibiotics
● Monitor signs of infection and to report to emergency if so
● Encouraged to have vitamin C and protein rich food.

Situational Task
Complications of an Inguinal Hernia.
● Pressure on surrounding tissues. Most inguinal hernias
enlarge over time if not repaired surgically. In men,
large hernias can extend into the scrotum, causing pain
and swelling.
● Incarcerated hernia. If the contents of the hernia
become trapped in the weak point in the abdominal wall,
the contents can obstruct the bowel, leading to severe
pain, nausea, vomiting, and the inability to have a
bowel movement or pass gas.
● Strangulation. An incarcerated hernia can cut off blood
flow to part of your intestine. Strangulation can lead
to the death of the affected bowel tissue. A
strangulated hernia is life-threatening and requires
immediate surgery.