FEMORAL MASS OR SWELLING

FEMORAL MASS OR SWELLING: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. Is it reducible? If the mass is reducible, it is most likely a femoral hernia or saphenous varix.
2. Is there an associated kyphotic curvature of the spine? The findings of a kyphotic curvature of the spine suggest a psoas abscess, which is usually tuberculous.
3. Is the mass firm and ovoid? A firm, ovoid mass suggests an enlarged lymph node or an ectopic testis.
4. Is there resonance or bowel sounds over the mass? These findings suggest a femoral hernia.
5. Is the corresponding half of the scrotum empty? These findings suggest an ectopic testis.

DIAGNOSTIC WORKUP

Surgical consultation may be wise at the outset. A reducible mass would suggest a femoral hernia, but an upper GI series with a small bowel follow-through would confirm this diagnosis. Of course, if it is felt that the femoral hernia is irreducible, this study would not be done, and exploratory surgery would be indicated. If the mass is suspected to be a lymph node, a biopsy should be done. If the mass is suspected to be an abscess, an incision and drainage should be done. If tuberculosis is suspected, a tuberculin test as well as an AFB smear and culture should be done. If the mass is suspected to be a saphenous varix, venography will confirm the diagnosis. Exploratory surgery of the groin will clarify the diagnosis in confusing cases.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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