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Incarcerated inguinal hernia — MCCQE Part 1 MCQ

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ModerateAbdominal / Pelvic MassIncarcerated inguinal herniaMCCQE Part 1

A 54-year-old man has a painful right groin lump that cannot be reduced, with vomiting and abdominal distension. The overlying skin is erythematous and he is febrile. Which of the following is the most appropriate next step?

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Correct answer: D — Urgent surgical assessment for incarcerated or strangulated hernia

A non-reducible painful hernia with vomiting, fever and skin changes suggests incarceration with possible strangulation and requires urgent surgery. Forceful reduction is unsafe when strangulation is suspected. Elective referral is for uncomplicated reducible hernias.

Reference: Canadian Association of General Surgeons practice; acute care surgery pathways