Makindo Medical Notes"One small step for man, one large step for Makindo" |
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A lump in the groin is a common clinical presentation. Causes range from benign cysts to surgical emergencies such as strangulated hernia. A careful history, examination, and targeted investigations are essential to guide management. ⚠️ Always consider red-flag features such as severe pain, systemic sepsis, or irreducibility, which require urgent intervention.
Diagnosis | Clinical Features | Key Tests | Management |
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Inguinal Hernia 🧳 | Soft, reducible lump; enlarges with cough/strain; painless unless strangulated | Clinical exam, cough impulse; US/CT if uncertain | Elective repair if reducible; 🚨 emergency surgery if incarcerated/strangulated |
Femoral Hernia 🚨 | Firm, tender lump below inguinal ligament; more common in women; high strangulation risk | Clinical exam; US/CT for confirmation | Urgent surgical repair |
Lymphadenopathy 🦠 | Enlarged nodes (tender = infection; hard/fixed = malignancy) | FBC, ESR/CRP; US ± FNA/biopsy; STI/TB tests | Treat infection; oncology referral if suspicious |
Femoral Artery Aneurysm ❤️ | Pulsatile lump; may cause distal ischaemia (cold/pale leg) | Doppler US; CT angiography | Vascular surgery; repair (open or endovascular) |
Sebaceous Cyst 💭 | Mobile, subcutaneous lump; may become inflamed or infected | Clinical exam; US if uncertain | Excision if symptomatic; antibiotics if infected |
Abscess 🔥 | Red, warm, fluctuant, very tender; systemic sepsis possible | Clinical exam; US for size/depth | Incision & drainage ± antibiotics |
Undescended Testis ⚽ | Absent testis in scrotum; palpable lump in groin (infants/children) | Clinical exam; US/MRI for localisation | Orchiopexy (surgical repositioning) |
💡 Exam Tip: Femoral hernias lie below the inguinal ligament and carry the highest risk of strangulation → always urgent surgical referral.