This document presents a case report of a 59-year-old male wood carpenter admitted to the hospital with a swelling in his right groin for 25 days and a history of constipation for a few months. On examination, the doctor found a reducible right inguinal hernia. Laboratory tests were performed. The provisional diagnosis was a right-sided complete reducible inguinal hernia, which was confirmed. The recommended treatment was herniotomy and herniorrhaphy under spinal anesthesia.

1. CASE PRESENTATION
BY
Dr. Nayeem Ahmed
Intern doctor
STAMCH

2. PARTICULARS OF PATIENT
 Name: Nur Hossain
 Age: 59 years
 Sex: Male
 Occupation : Wood Carpenter
 Address: Aralia, Kapasia, Gazipur
 Martial Status : Married
 Date of Admission: 16-05-22
 Date of examination: 17-05-22

3. PRESENTING COMPLAINTS
 Swelling in the Right groin from 25 days
 Constipation for few months

4. HISTORY OF PRESENTING ILLNESS
 According to the statement of the patient, he was
apparently normal 25 days back. Then he developed right
groin swelling which is non tender, reducible. He has history
of constipation for few months.

5. HISTORY OF PAST ILLNESS
 Patient is non Diabetic
 Patient is non hypertensive
 No history of previous surgery.
 No history of Allergy.

6. DRUG HISTORY
He is taking Rabeprazole for few months

7. PERSONAL HISTORY
 Consumes mixed diet
 No adverse social habits
 No high risk behaviour
 Smoking 6-8 cigarette/day for 30 yers
 Habit of chewing betel leaf for few yeras
 Constipation for few months
 Normal sleep pattern

8. FAMILY HISTORY
 No history of DM in the family.

9. GENERAL EXAMINATION
 Appearance: Normal
 Body built: average.
 Anemia : absent
 Jaundice : absent
 Clubbing: absent
 Cyanosis: absent
 Lymphadenopathy: absent
 Pedal edema: absent
BP : 120/70 mmHg
Pulse : 70 bpm
Respiratory Rate: 18 b/min
Temperature : normal

10. LOCAL EXAMINATION
INSPECTION
A swelling is present in the Right inguino scrotal region.
Left side is normal.
Visible cough impulse : Present

11. PALPATION
1.No local rise of temperature
2. The swelling is non tender
3. Reducibility : The swelling is reducible
4. To get above the swelling : Not possible
5. Deep ring occlusion test : Positive

12. Systemic Examination
 Cardiovascular : S1, S2 heard, no murmur present.
 Respiratory : Trachea in midline, bilateral equal air
entry is present, vesicular breath sounds are heard, no
added sounds.
 Per Abdomen: soft, non tender & no organomegaly is
present.
 CNS: No focal neurological deficit is found.

13. SALIENT FEATURES

14. PROVISIONAL DIAGNOSIS
Rights sided complete, reducible inguinal hernia.

15. Differential Diagnosis
1. Right sided Hydrocele
2.Right sided epididymal cyst

16. INVESTIGATIONS
 GENERAL INVESTIGATIONS
 CBC - Hb - 9.5,g/dl , ESR - 57,mm/1st hr , WBC - 57%
 USG W/A - Normal
 RBS- 7.0 mmol/L
 Urine R/E - Normal
 HbsAg- negative
 Anti HCV- negative
 Urine for ketone bodies
 Serum creatinine - 0.8 mg/dL

17. Confirmed diagnosis
Rights sided complete, reducible inguinal hernia.

18. TREATMENT
 Herniotomy, Herniorrhaphy under spinal anesthesia

19. THANK YOU