Infant inguinal hernia - reducible vs incarcerated
HIGH-YIELD
Appears 3×
Teaching point — how the wording changes the answer
A soft, non-tender, reducible infant inguinal hernia (no erythema) is referred to a paediatric surgeon for prompt elective herniotomy because of high incarceration risk; diagnosis is clinical. A tender, irreducible, erythematous mass in an unwell baby is incarcerated/strangulated - an emergency needing urgent surgery, not delaying ultrasound.
Q25
Male baby with a soft groin/penile-area mass visible on crying, now irritable but mass soft; next step?
Key clue
Soft, non-tender, reducible = not incarcerated
Show answer
Refer to paediatric surgeon for elective herniotomy
Q26
Male baby with a tender, non-reducible inguinal mass and erythema; next step?
Key clue
Tender + irreducible + erythema = incarcerated/strangulated
Show answer
Emergency surgical referral (avoid delaying ultrasound)
Q127
1-year-old with a tender groin mass plus nausea and vomiting; further investigation?
Key clue
Strangulated hernia - clinical, needs urgent repair
Show answer
No investigation - urgent surgical repair (Doppler USS only if uncertain/incarcerated)