elderly frail ladies
Inspection:
- mass over groin area
- +/- surgical scars
- +/- cough impulse (small neck)
Palpate:
- cough impulse
- pubic tubercle (trace adductor muscle) - below and lateral
- reduce if possible
Auscultate:
- bowel sounds - stangulation (high pitch)
determine fitness for surgery
Mx:
- early repair - high stranglation risk
- high approach
- extraperitoneal/Mc Evedy - strangulated hernia
- intraperitoneal/ Lothiessen (inguinal)
