BED SIDE TEACHING (BST)HERNIA INGUINALIS LATERALIS DEXTRA

REPONIBLE

Indra Destia12100113043

Preceptor :Dr. Liza N., Sp.B.,M.Kes.,FinaCS

Surgical DepartmentFaculty of Medicine

Universitas Islam BandungRS Al-Islam Bandung

Patient’s IdentityName : AFSex : BoyAge : 8 years oldAddress : Buah Batu, BandungOccupation : StudentReligion : MoeslemDate of Admission : April 16th 2014Date of examination : April 16th 2014

AnamnesisChief Complaint : Lump at right groinPresent of Illness :

Patient comes to the hospital with complaint lump at right groin. According to his parents, the lump appeared since one year ago. Lump appear suddenly, the measuring about 3 cm, and it enlarged from the initial complaint.

The lump seen when patient doing activity, straining, coughing, and disappear when the patient was sleeping. The lump can be entered into the abdominal cavity without help. The lump is not painful, and was not accompanied by abdominal distended, nausea, vomiting, or difficult in bowel habit. Complaints are not accompanied by redness of the skin over the lump, or body heat.

No history of previous trauma, patients have not been treating this complaint, and no family history of similar complaints.

Physical ExaminationGeneral StatusConsciousness : ComposmentisGeneral appearance : mild illnessVital Sign

- BP : 120/80 mmHg- PR : 80 x/minute- RR : 22 x/minute- Temperatur : 36,8 oC

Head : Normochepal- Eye : Conjunctiva anemis (-/-) Sclera icteric (-/-) Pupil Reflex +/+, isochor- Nose : septum deviation (-), secret -/-- Mouth : moist mucosa- Neck : no enlarged of lymph node

Thorax : Symmetrical movementLung : Retraction -/-, VBS +/+, Ronchi

-/-. Wheezing -/-Heart : Ictus cordis (-), border at ICS IV

midclaviculari line, heart sound (1&2) regular.

Gallop (-), Murmur (-)Abdomen : Flat, tenderrness (-), no palpable enlargement of the

liver, and spleen. Tymphani

(+), Bowel sound (+) normal

Extremities: Superior : Edema -/-, cyanosis -/-, deformity -/-,

Warm acral, CRT <2 secondsInferior : Edema -/-, cyanosis -/-, deformity -/-,

Warm acral, CRT <2 seconds

Localized Status :a/r inguinalis dextrahiperemis (-), edema (-), tenderness (-), valsava test (+), finger test (+) lump at fingertip

ResumeA boy 8 years old came to the hospital, with complaints lump at right groin. The lump appeared since one year ago. Lump appear suddenly, measuring about 3 cm, and enlarged from the initial complaint.The lump seen when patient doing activity, straining, coughing, and disappear when the patient was sleeping. The lump is reponible.

The lump is not painful, nausea (-), vomiting

(-), difficult bowel habit(-), redness of the skin over the lump (-), body heat (-).

From physical examination, generalis status within normal limits. Localize status obtained from the a/r inguinal dextra, valsava test (+), finger test (+) lump at fingertip.

Differential diagnosisHernia Inguinalis Lateralis Dextra ReponibleLymphadenopathy

Diagnostic examinationRoutine hematologyUSG abdomen

Work DiagnosisHernia Inguinalis Lateralis Dextra Reponible

ManagementHerniotomy

Prognosis Ad vitam : ad bonamAd functionam : ad bonamAd sanationam : ad bonam

THANK YOU