75 years male patient with bipedal edema and swelling in left ingunoscrotal region



A 75 years old male patient attended to
 opd with bipedal edema and facial puffines10   days ago and swelling over  the left ingunoscrotal region since one year 

Patient was apparently alright 1 year back when he developed swelling in the left ingual region which was intially small in size thn grew to its current size.

It intially used to reduce on lying down and increases on working 

History of present illness: swelling was associated with pain which was of dragging type which developed three days before.He isn't able to reduce the swelling since three days.No complaints of constipation,no complaints of vomiting,no complaints of burning micturition and loose stools.

History of past illness:he is complaing of edema which is bilateral associated with morning puffiness 

No surgical history 

No history of HTN/DM/ASTHMA/EPILEPSY 

Personal history:

 Sleep: adequate  

Diet:mixed diet 

Bowel: constipation 

Micturition: normal

Addictions:alcoholic ,smoking

Family history:no history of similar complaints in the family 

Treatment history:no history of drug allergies 

On general physical examination: patient was conscious coherent and cooperative

No pallor 

No cyanosis 

No lymphadenopathy 

Vitals:

Temperature: Afebrile

Respiratory rate:15/min

Pulse rate:80/min 

Bp:160/90 

GRBS:140mg

Systemic examination:

Cardiovascular system:

No murmurs 

No thrills 

S1 s2 sounds heard 

Respiratory system 

No dyspnea 

No wheeze 

Position of trachea-central 

Abdomen:

Shape of abdomen-obese

No tenderness 

No palpABle mass 

Irreducible indirect lingual hernia

CNS system:

Conscious

Speech normal 

Reflex normal 

Provisional diagnosis: irreducible  indirect incomplete inguinal hernia

Investigations:


 






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