Hernia and abdominal wall: incarcerated infant inguinal hernia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia and abdominal wall: incarcerated infant inguinal hernia

Sample item

A 2-month-old boy has a tense, tender swelling in the right groin and irritability. He has no abdominal distension, peritonitis or skin discolouration. What is the best initial management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Sedation and gentle manual reduction, then herniotomy after oedema settles

A tender incarcerated infant inguinal hernia without signs of strangulation is gently reduced with analgesia or sedation. Herniotomy is then done after a day or two, once oedema has settled, because early operation on an oedematous cord is difficult. Emergency surgery is reserved for failed reduction or strangulation.

Option by option

  • A. Sedation and gentle manual reduction, then herniotomy after oedema settles (correct)

    Correct. Gentle reduction with sedation, followed by delayed herniotomy, is standard when there is no strangulation.

  • B. Immediate laparotomy with bowel resection

    Immediate laparotomy and resection is for failed reduction with strangulation, which is not present.

  • C. Observation with review in 6 weeks

    Observation is unsafe because an incarcerated hernia can strangulate within hours.

  • D. Elective herniotomy at 1 year of age

    Waiting until one year leaves an infant at risk of repeated incarceration, which is common at this age.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Sedation and gentle manual reduction, then herniotomy after oedema settles. A tender incarcerated infant inguinal hernia without signs of strangulation is gently reduced with analgesia or sedation.

Why is "Immediate laparotomy with bowel resection" not the answer?

Immediate laparotomy and resection is for failed reduction with strangulation, which is not present.

Why is "Observation with review in 6 weeks" not the answer?

Observation is unsafe because an incarcerated hernia can strangulate within hours.

Why is "Elective herniotomy at 1 year of age" not the answer?

Waiting until one year leaves an infant at risk of repeated incarceration, which is common at this age.

What concept does this question test?

It tests Hernia and abdominal wall: incarcerated infant inguinal hernia in General Surgery. Herniotomy is then done after a day or two, once oedema has settled, because early operation on an oedematous cord is difficult. Emergency surgery is reserved for failed reduction or strangulation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia and abdominal wall: incarcerated infant inguinal hernia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.