6 Hours Of Sudden in Surgery — 58yo Man | General Surgery | SMLE Q#11229
SMLE Question #11229
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 58-year-old man with a 5-year history of a right inguinal hernia presents with 6 hours of sudden severe lower abdominal pain and repeated non-bilious vomiting. Earlier today, he manually reduced a painful right groin bulge with more difficulty than usual; since then, the bulge has not reappeared. He has worsening crampy abdominal pain and is unable to pass flatus. Examination shows mild abdominal distension and hyperactive bowel sounds, with no palpable inguinal or scrotal mass. What is the most appropriate next step in management?
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