33 Examination of the groin and scrotum
The groin
Introduction
The patient should be asked about any pain and then asked to stand up and unclothe from nipples to knees. The locations of groin hernias are shown in Fig. 3.5.1. Causes of groin lumps are:
lymphocele: following femoral artery surgery in the groin, the local lymphatics may become disrupted, and a local collection of lymphatic fluid forms a lump; it can be simply aspirated
ectopic testis: the testis is absent from the scrotum; feeling along the line of the inguinal ligament should detect an undescended testes
saphena varix: bluish tinge, has a cough impulse, disappears on lying; varicose veins may be present
psoas abscess: in the psoas muscle (Crohn’s disease or tuberculosis): deep and fluctuant, causing fixed flexion of the hip.
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