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Incarcerated inguinal hernia — USMLE Step 2 CK MCQ

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ModerateSurgeryIncarcerated inguinal herniaUSMLE Step 2 CK

A 34-year-old African American man comes to the urgent care clinic because of abdominal pain or gastrointestinal symptoms. History and focused examination are notable for painful irreducible groin bulge with vomiting and bowel obstruction. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most likely diagnosis?

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Correct answer: B — Incarcerated inguinal hernia

The vignette describes Incarcerated inguinal hernia, supported by painful irreducible groin bulge with vomiting and bowel obstruction. Incarcerated inguinal hernia is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-86