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Incarcerated hernia — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Incarcerated herniaUSMLE Step 3

A 59-year-old has a painful irreducible groin bulge, vomiting, abdominal distension, tachycardia, and localized tenderness. Which next step is best?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Begin resuscitation and obtain urgent surgical assessment

This presentation suggests an incarcerated hernia with possible obstruction or strangulation and needs urgent surgical assessment while resuscitation begins. Elective review and delayed conservative measures are unsafe.

Reference: American College of Surgeons: Adult Inguinal and Femoral Groin Hernia Repair: https://www.facs.org/for-patients/the-day-of-your-surgery/adult-inguinal-and-femoral-groin-hernia-repair/