Expansile Cough Impulse in Surgery — 65yo Man | General Surgery | SMLE Q#11743

SMLE Question #11743

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: February 2026
A 65-year-old man has a 1-year history of a right groin swelling that becomes more prominent on standing or coughing and reduces when supine. He reports mild discomfort and a dragging sensation by the end of the day but no vomiting, bowel obstruction symptoms, or prior irreducibility. Examination shows a soft, reducible inguinal swelling with an expansile cough impulse and no features of strangulation. What is the most appropriate management strategy for this patient at this time?

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