Swellings


Groin Swellings


These are common clinical problems, especially hernias. They are therefore common in clinical examinations.




History



Sebaceous cyst


The patient will complain of a mobile lump on the skin. It may be red and inflamed and discharging.



Lipoma


The patient will present with a soft, painless swelling.



Hernias


A patient with a groin hernia will present with a lump that disappears on recumbency or may be pushed back (reducible). The patient may present with a tense, tender lump that will not reduce and is accompanied by signs and symptoms of intestinal obstruction. Femoral hernia is more common in females. With hernias, there is occasionally a history of sudden straining or trauma, following which a lump may become manifest.



Imperfectly descended testis


An imperfectly descended testis may present as a groin swelling. The patient, or, if in a young child, the mother, will have noticed absence of a testis from the scrotum. Enlargement and pain may indicate malignant change, which is more common in an imperfectly descended testis.



Lipoma of the cord


The patient will have noticed a soft swelling in the groin. This is often mistaken for a hernia.



Hydrocele of the cord


This may present as a lump in the inguinal region which does not reduce.



Hydrocele of the canal of Nuck


This is similar to a hydrocele of the spermatic cord but presents in the female. It represents a cyst forming in the processus vaginalis.




Saphena varix


A saphena varix is normally associated with varicose veins lower down the leg. The patient will present having noticed a small, soft, bluish mass in the lower part of the groin.



Femoral artery aneurysm


A pulsatile expansile mass suggests a femoral aneurysm. Check for a history of arterial surgery at the groin or arteriography via the femoral artery, which may suggest the presence of a false aneurysm.



Imperfectly descended testis


An imperfectly descended testis may descend into the upper thigh but its descent is arrested by the attachment of Scarpa’s fascia to the deep fascia of the thigh.

Stay updated, free articles. Join our Telegram channel

May 18, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Swellings

Full access? Get Clinical Tree

Get Clinical Tree app for offline access