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 palpationgenitourinary: 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.

Other active problems:

Hypertension

Medical, surgical, obstetric, hospitalizations:

Kidney stone requiring lithotripsy

Allergies:

None

Medications:

Lisinopril

Preventive Health:

Cancer-screening modalities for gender/age: prostate examRecommend smoking cessation - patient not ready Fitness: encouraging increasing exerciseNutrition: recommending better choices when eats outStress reduction: exercise recommendation

Immunizations:

Up to date

FHx:

Father: Hypertension, CAD, prostate cancerMother: Hypothyroidism, breast cancerSiblings: None

SHx:

Marital status/personal support system: Married x 20 yearsHousing: CondominiumOccupation: AccountantTobacco use: Smokes 1 ppd; Alcohol: 1 to 2 drinks/day; History of: narcotic abuse (Percocet)Sexual history: Monogamous