Differential Diagnosis
- Single most likely diagnosis
- C. Obstructed hernia: This is the most likely diagnosis given the patient's symptoms of abdominal distension, vomiting, constipation, and an irreducible inguinal swelling. These symptoms suggest a bowel obstruction, which is consistent with an obstructed hernia.
- Other Likely diagnoses
- B. Incarcerated hernia: An incarcerated hernia occurs when a hernia becomes trapped and cannot be reduced. While the patient's hernia is described as irreducible, the presence of abdominal distension, vomiting, and constipation suggests that obstruction is also a concern, making incarcerated hernia less likely but still possible.
- A. Irreducible hernia: This diagnosis is also possible, as the patient's hernia is described as irreducible. However, the additional symptoms of abdominal distension, vomiting, and constipation suggest that there may be more going on than just an irreducible hernia.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- D. Strangulated hernia: A strangulated hernia is a medical emergency that occurs when the blood supply to the herniated tissue is cut off. While the patient does not have fever, which is often a symptom of strangulation, the possibility of strangulation should not be missed due to its high morbidity and mortality.
- Rare diagnoses
- Other rare diagnoses, such as a sliding hernia or a hernia with an unusual content (e.g., ovary, bladder), could be considered but are less likely given the patient's presentation.