6 Hours Of Sudden in Surgery — 58yo Man | General Surgery | SMLE Q#927
SMLE Question #927
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 58-year-old man presents with 6 hours of sudden severe diffuse abdominal pain. He has a known paraumbilical hernia previously reducible, now painful and irreducible. He has nausea, vomiting, and has not passed flatus since onset. Examination shows a tender, firm, irreducible paraumbilical mass with overlying erythema, reduced bowel sounds, and diffuse abdominal tenderness with mild guarding. What is the most appropriate next step in management?
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