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NBME 21 Answers

nbme21/Block 4/Question#47

While lifting weights, a 24-year-old man develops a ...

Strangulation

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submitted by pparalpha(19),

The inguinal part of the question points you to a a femoral hernia

Femoral hernia: uncommon type of inguinal hernia, in which intra-abdominal contents (in this case the small bowel) herniate into the femoral canal through the femoral ring

The image: strangulation: ischemic necrosis of contents within the hernia sac as blood flow is compromised due to incarceration (irreducible femoral hernia due to trapped hernia contents in hernia sac)

So, in short: femoral hernia can lead to a complication called incarceration which can lead to strangulation





Femoral Hernia- More likely to present with incarcerations strangulation than inguinal hernias. Strangulation cuts off blood flow which results in ischemia and necrosis (pain/red/swollen), and incarceration results in bowel being trapped in hernia





There is nothing indicating that this is a femoral hernia. It could be any type of hernia in the inguinal region (femoral, direct of indirect inguinal). No need to overthink: symptoms of incarceration, piece of dead bowel - strangulation, done, keep going.