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- W4239776870 abstract "Considering the anatomy and associated pathology in a systematic fashion, the lump may represent: • Psoas sheath → psoas abscess or psoas bursa • Femoral nerve → neuroma • Femoral artery → femoral aneurysm or pseudoaneurysm • Femoral vein/long saphenous vein → saphena varix (dilated great saphenous vein due to incompetence at the saphenofemoral junction) • Lymph nodes → lymphadenopathy (infectious or malignant) • Hernial orifices → inguinal hernia, femoral hernia • Testicular apparatus → ectopic testis, undescended testis, hydrocele of cord • Skin/subcutis → lipoma, infected abscess (e.g. from intravenous (IV) drug use), sebaceous cyst. In common with lumps anywhere on the body, you will need to establish: • How long has the lump been there? Many of the diagnoses listed in Figure 24.1 will develop rather insidiously, but there are some that may have a rather shorter history. For example, a patient may develop a femoral artery pseudoaneurysm (a collection of blood outside the vessel lumen) following angiography, a direct inguinal hernia may be precipitated by a period of heavy lifting, or inguinal lymphadenopathy may follow a lower limb infection. Ectopic or undescended testes would be present from birth, but it is extremely unlikely that a man would reach adulthood in the Western world without having had this defect corrected by orchidopexy (orchid = testis, -pexy = fixation in correct position) or orchidectomy (orchid = testis, -ectomy = removal). • Is the lump always there? Does it reduce when the patient lies down? This question relates to hernias and saphena varix. Increases in intra-abdominal pressure, for example during coughing or straining at stool, may cause hernias to increase in size. A saphena varix may increase in size if the patient stands for long periods of time as retrograde flow through incompetent venous valves will allow blood to pool. A saphena varix will disappear completely when the patient lies down. • Has the lump got bigger, smaller, or stayed the same size? Almost all of the pathologies on our differential (with the possible exception of ectopic/undescended testes) may change in size over time." @default.
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- W4239776870 date "2015-10-08" @default.
- W4239776870 modified "2023-09-24" @default.
- W4239776870 title "Groin lump" @default.
- W4239776870 doi "https://doi.org/10.1093/oso/9780198716228.003.0030" @default.
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