Surgery
Inguinal Hernia Management
Watch-and-wait vs surgical repair; recognise strangulation; open vs laparoscopic; mesh considerations.
Source: European Hernia Society 2018; BHS
Step 1 of ~6
info
Diagnosis + Differential
History: groin lump, ± dragging discomfort, worse on coughing / lifting / standing, reducible. Distinguish:
• Direct (medial to inferior epigastric vessels) vs indirect (lateral); both repaired similarly.
• Femoral hernia (below inguinal ligament; high risk of strangulation; surgical priority).
• Differentials: lymph node, lipoma, sebaceous cyst, vascular (saphena varix), psoas abscess, undescended testis.
USS or MRI if doubt; herniogram rarely used.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Cefuroxime · Second-Generation Cephalosporin — Respiratory / Surgical Prophylaxis
- Methotrexate (Ectopic) · Antimetabolite (Ectopic Pregnancy Management)
- Co-amoxiclav (Open Fracture Antibiotic Prophylaxis) · Beta-lactam / Beta-lactamase Inhibitor Combination
Pathways
- Major Trauma — Primary Survey (ATLS) · ATLS 10th Edition; JRCALC; NICE NG39
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Burns — TBSA Estimation & Fluid Resuscitation · British Burn Association; EMSB; RCEM 2024
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Hypertrophic Pyloric Stenosis · BAPS / RCPCH
Decision support only. Always apply local guidelines and clinical judgement.