Abdominal Surgery (Demo)

A 78-year-old woman presents with colicky abdominal pain and a tender mass in her groin. On examination, there is a small, firm mass below and lateral to the pubic tubercle. What is the most likely underlying diagnosis?

A 53-year-old man with a history of diverticular disease and a previous loop colostomy for perforated diverticulitis undergoes a reversal of his loop colostomy 10 days ago. He has been recovering well postoperatively and was discharged home after a stable hospital stay. He presents to the emergency department with a 24-hour history of vomiting, colicky abdominal pain, and bloating. He describes the pain as crampy, localized to the lower abdomen, and worsening after meals. On examination, there is a swelling at the site of his previous loop colostomy. The swelling is firm, tender to palpation, and associated with slight erythema of the skin over the mass. There are no signs of fever or peritonitis, and his vital signs are stable, with a blood pressure of 120/75 mmHg, pulse rate of 100 bpm, and temperature of 37.1°C. His abdomen is soft, but there is mild distension. What is the most likely underlying diagnosis?

A 10-year-old boy is brought to his doctor for a routine check-up. During the examination, a smooth, mobile swelling is noticed in the right iliac fossa. The child is otherwise healthy, without any signs of systemic illness or discomfort. He has no history of trauma or gastrointestinal symptoms. The doctor suspects that the swelling could be related to an abdominal structure. What is the most likely diagnosis?

A 33-year-old pregnant woman at 32 weeks gestation presents with severe abdominal pain, vomiting, and signs of shock. A perforated abdominal viscus is suspected. Considering the risks to both the mother and fetus, what is the most appropriate diagnostic approach to confirm the suspected diagnosis?

A 72-year-old woman presents with a palpable swelling in her groin. On examination, a small, firm mass is felt in her right lower abdomen. The mass is tender, and she is at risk for complications related to this type of hernia. The physician suspects a femoral hernia. At which of the following sites is it most likely to be identified clinically?