Patient case: Incisional Hernia
A 55-year-old male presents to the outpatient clinic with complaints of a noticeable bulge in his abdomen near an old surgical scar. He underwent an open appendectomy five years ago and has since noticed that the area around the scar has become increasingly prominent, especially when he coughs, lifts heavy objects, or performs physical activities. The patient reports mild discomfort at the site, but denies any significant pain or changes in bowel habits.
On physical examination, a soft, reducible mass is observed at the site of the surgical scar. The bulge increases in size with Valsalva maneuver but is non-tender and does not exhibit signs of strangulation. The patient's medical history is notable for obesity and controlled type 2 diabetes.
To confirm the diagnosis, an abdominal ultrasound is performed, which reveals an incisional hernia at the previous surgical site. After discussing treatment options, the patient expresses interest in surgical repair. He is scheduled for laparoscopic hernia repair in three weeks, with a discussion about preoperative care and postoperative recovery provided during the visit.
a). Severe abdominal pain and vomiting
b). Noticeable bulge at a surgical scar and mild discomfort
c). Fever and chills
d). Diarrhea and constipation
a). Laparoscopic cholecystectomy
b). Open appendectomy
c). Hernia repair surgery
d). Gastric bypass surgery
a). Firm, non-reducible mass in the right flank
b). Soft, reducible mass at the site of the surgical scar
c). Abdominal distension with tenderness
d). Hyperactive bowel sounds
a). Abdominal X-ray
b). CT scan of the abdomen
c). Abdominal ultrasound
d). MRI of the abdomen
