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JAMA Surgery Clinical Challenge |

Painful Right Inguinal Swelling QUIZ

Florian Fanget, MD1; Eddy Cotte, MD, PhD1,2; Kayvan Mohkam, MD2,3
[+] Author Affiliations
1Department of Digestive Surgery and Surgical Oncology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Lyon, France
2Equipe Mixte de Recherche 3738, Ecole Doctorale EDISS 205, Université Claude Bernard Lyon I, Lyon, France
3Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
JAMA Surg. 2016;151(3):285-286. doi:10.1001/jamasurg.2015.2766.
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A 69-year-old man presented to the emergency department with a 5-day history of painful irreducible right inguinal swelling, a normal white blood cell count, and a hypodense mass on computed tomographic imaging. What is your diagnosis?

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Figure 1.
Abdominopelvic computed tomography images show axial (A) and multiplanar reformatted (B) views. A indicates anterior; AR, anterior right; FL, foot left; HR, head right; L, left; P, posterior; PL, posterior left; and R, right.
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Figure 2.
A low curved inguinal incision allowed appropriate exposure for both femoral canal repair and appendectomy.
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