Cough Impulse in Surgery — 60yo Man | General Surgery | SMLE Q#18428

SMLE Question #18428

Surgery General Surgery

Objective: OBJ-INGHERN-001

Last updated: February 2026
A 60-year-old man attends a primary care clinic for a routine check. He reports a right groin bulge that is more noticeable after prolonged standing and disappears when he lies down. He has mild intermittent discomfort without limitation of daily activities. He denies nausea, vomiting, abdominal distension, obstipation, fever, or severe pain. Examination shows a soft, reducible right inguinal bulge with a cough impulse and normal overlying skin. What is the most appropriate management?

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