discussion

Jack Baldwin is a 50 years old man who come to the hospital c/o left groin sharp pain that irradiate to the left testicle that started 6 hours ago, he feels nausea and threw up once. he stated he was helping a friend with some moving when the pain started. Standing makes it worse, especially standing up straight and bending over makes it worse, too. I haven't found anything that makes it better. My scrotum feels achy mostly on the left side.

Physical Exam: HR:130 BP:170/94

skin:Diaphoretic

abdomen: Visible swelling in the left groin with extension into the scrotum, without erythema
•Mildly swollen, indurated left groin causing tension to overlying skin
•Diffuse left-groin tenderness to palpation
genitourinary: The left groin region is visibly swollen and indurated to palpation. Right side normal.
•There is tenderness within the left inguinal canal; right inguinal canal normal;
•The scrotum is swollen on left side
•The testicles are normal in size and nontender to palpation
•Normal penile shaft, without lesions or discharge
•No flank tenderness to percussion

Differential diagnosis:

- hernia, inguinal

- epididymitis

- testicular torsion

- nephrolitiasis/ kidney calculi

Final diagnosis:

hernia, inguinal

Scrotal ultrasound reveals the following:

• Loop of bowel in the left scrotum
• Normal blood flow to each testicle
• Normal testicular size bilaterally

QUESTIONS:

• Provide a reference for your treatment plan (in APA format). The reference may come from a journal, a book, etc.
• Cite all sources using APA format.
• Include three differential diagnoses and support your diagnoses with supporting literature.