Case Clerking 59w64

KURSUS DIPLOMA PEMBANTU PERUBATAN CASE CLERKING NAMA PELATIH: SAMSON GAN NO MATRIKS: BPP2010-3373 TAHUN: 2 SEMESTER: 2 KAWASAN PENEMPATAN: HOSPITAL DAERAH TENOM

BAHAGIAN 1 : BUTIR-BUTIR PERIBADI PESAKIT No. Pendaftaran : 1695 Nama : Masri Bin Bakri TINGKALOR EPANG -TIDAK PERLU DIISIJantina: Lelaki Bangsa: Murut Alamat : Kg. Abul, Kemabong Tenom Sabah. -TIDAK PERLU DIISIHospital/Klinik: Hospital Daerah Tenom

NOMBOR K/P: 571119-12-5249 -TIDAK PERLU DIISI-

Pekerjaan : Petani

Umur : 54 tahun No. Tel: -TIDAK PERLU DIISI-

Tarikh: Tarikh masuk wad: 22/06/2010 Tarikh keluar wad: 29/06/2010

PART 2: PATIENT’S HISTORY CHIEF COMPLAIN 

Complaint of right hipocondriac pain since 5 days ago HISTORY OF PRESENT ILLNESS





or below part of his right shoulder. Other sign and symptom that shown and was complaint by the patient was - Fever - Chills - Rigor - Nausea - Vomiting - Lost of appetite - Tachycardia the laboratory test for the patient blood also shown the increasing number of leucocyte

  

known as leucocytosis. Test for Murphy’s Sign is positive- Tender right upper quadrant Ortner’s Sign- Tenderness when hands taps the edge of right costal arch. Geogievskiy- Myussi’s Sign (phrenic nerve sign) – Pain when press between edges of



sternocleidomastoid. Boas’s Sign – increased sensitivity below the right scapula (also due to phrenic nerve



irritation). When the palpation maded, mass can be easily palpated on the right hipocondriac region

  

on patient the body. No history of trauma or fall. No difficulty in oral intake. No abnormality in bowel or urinary noted.



1.5

Patient felt that the pain that come from the right hipocondriac region spread to the back

PAST MEDICAL / SURGICAL HISTORY  5 years ago, patient was itted to the same hospital in Tenom diagnosed having Chronic obstructive airway disease(COAD) and Pulmonary Tuberculosis(PTB).  No history of past surgical history.  No history of any allergies.

1.6

FAMILY HISTORY

 1.7

Not history of Diabettes Mellitus and Hypertension among family . SOCIAL HISTORY



Smoker: ex smoker(above 10 sticks a day since he was 20 years old and stopped smoking



when he was 49 years old. ) Alcohol drinker: ex drinker (approximately 3 bottle of alchohol for 1 weeks since he was 20 years old and stopped drink alchohol when he was 49 years old. )

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PART 2 2.1

PHYSICAL EXAMINATION

GENERAL    

Patient was in pain. Alert and concious Not respiratory distress. No pallor and central cyanosis noted. Vital signs:

Blood pressure: 107/60 mmhg Temperature: 38.3 degree centigrade Pulse rate: 86/ minute Respiratory rate: 20/ minute SpO2: 98% Pulse rhythm: Regular Pain score: 4

2.2 PHYSICAL 2.2.1 HEAD



 2.2.2

2.2.3

Inspection o No swelling or active bleeding. o Yellowing of the skin. Palpation o No swelling.

EYES  Inspection o No blurring of vision. o No discharged found from both of the eyes. o Yellowing of the white eyes (jaundice).  Palpation o No periorbital tenderness or swelling noted. EARS  Inspection o No active bleeding or swelling. o Both ears remain in same size. o No discharged at both ears noted. o No abnormalities of hearing noted.  Palpation o No tenderness o No mass palpated.

2.2.4

NOSE  Inspection o No bleeding and swelling. o In normal shape of nose. o No discharged from the nose. o No nasal polyps seen. o No nasal obstruction noted.  Palpation o No tenderness. o No mass found.

2.2.5  o o

THROAT Inspection No inflammation around the throat. No tonsil enlargement.

2.2.6

MOUTH  Inspection o Normal in shape o Dry lips NECK  Inspection o No abnormality in shape o No complaint of dysphagia. o No swelling. o Able to swallowed  Palpation o No tenderness

2.2.7

o No mass palpable o No lymph node swelling 2.2.8

RESPIRATORY SYSTEM 







2.2.9

Inspection o Shape and symmetry of chest- Normal. o Chest wall movement anteriorly and posteriorly- Normal and no abnormalities o No coughing. o No breathlessness Palpation o Chest expansion- Normal o Apex beat- Normal o No vocal (tactile) fremitus. o Ribs- no pain localised. Percussion o Cardiac dullness- Normal. o Normal resonance at both lungs. Auscultation o Breath sound- No ronchi, no crepetations. o No added (adventitious) sounds. o Air entry equal bilateral

CARDIOVASCULAR SYSTEM  Inspection o No previous cardiac operation scars on the chest wall. o No abnormalities seen. 

 

Palpation o No chest wall pain or tenderness. o No presence of abnormal thrill. o Apex beat at 5th intercostals space midclavicular line. Percussion o Normal cardiac dullness on the fifth intercostal space of the left heart border. Auscultation o Sound 1 and sound 2 heard clearly. o Dual rhythm no murmur. o Heart beat- Normal

2.2.10 ABDOMEN  Inspection



o Right hipocondriac region noted.  Reducible.  Not extending to scrotum.  Cough impulse present.  No sign of strangulation or obstruction. o No surgical scar seen. o No wound. Palpation o Left inguinal hernia.  Reducible  Cough impulse present

 Tender over the swelling area. o Abdomen is tender





Percussion o Normal resonance. o No fluid thrill. Auscultation o Bowel sound present: 6 times per minute o No bruit sound heard.

2.2.11 GENITALIA o Left scrotal hydrocele noted. 2.2.12 RECTUM o Physical examination not done. 2.2.13 PELVIC  Inspection o Nothing abnormality noted.  Palpation o Nothing abnormality noted. 2.2.14 UPPER EXTREMITIES (RIGHT AND LEFT) o No deformity / abnormality seen. o Able to move both hands without restrictions. Upper Extremity Muscle Tone Muscle Power* a. Shoulder b. Elbow c. Wrise Refleks** a. Biseps b. Triseps c. Brachioradialis Sensation Test

Right

Left

Normatania

Normatania

5/5

5/5

2+ 2+ 2+ Intact

2+ 2+ 2+ Intact

Table 2.1 Result Of Patient’s Muscle And Tendon Reflexes For Upper Extremities

2.2.15 LOWER EXTREMITIES (RIGHT AND LEFT) o Right Leg & Left Leg  No deformity / abnormality detected.  No loss of sensation.  No pitting oedema.  Able to move right leg without restriction.  Capillary refill 2 seconds.  Posterior tibia artery and dorsalis pedis artery are palpable.

Lower Extremity Muscle Tone Muscle Power* a. Hips Refleks** b. Quadriceps c. Angkle Jirk d. Plantar Refleks Sensation Test

Right

Left

Normatania

Normatania

5/5

5/5

++ ++ ++

++ ++ ++

Intact

Intact

Table 2.2 Result Of Patient’s Muscle And Tendon Reflexes For Lower Extremitie

SCORE 5 4 3 2 1 0

DESCRIPTION Normal power or muscle strenght in extremities Weak extremities, but patient can overcome resistance applied by examiner Patient can overcome gravity (can lift extremities) but cannot overcome resistance applied by examiner Weak muscle contraction, but not enough to overcome gravity (movement, but cannot lift extremities) Palpable or visible muscle flicker or twitch, but no movement No response to stimulus, complete paralysis Table 2.3 Muscle Strength Scale*

SCORE 0 1+ 2+ 3+ 4+ reflexes**

DESCRIPTION Absent Disminished Normal Increased, more brisk than average Hyperactive, clonus

Table 2.4 Scale for deep tendon

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PART 3

SUMMARIES AND RELEVAN IMPORTANT FINDING

General Condition:

Alert, in pain, GCS: 15/15

ENT -not cyanosis,no ABDOMEN swelling -schafoid -no bleeding -soft,non tender, -liver,spleen, NECK kidney not palpable. -Normal shapepresent -bowel sound -JVP not raised -Lt. Inguinal hernia -noted. trachea not shifted -tender. -reduceble. -not extendig to scrotum. -Cough impulse present.

EYES -no hematoma -Pink -both pupil equel & react to light CARDOIVASCULAR -DRNM -regular heart beat

RESPIRATORY - clear -equal air entry

GENETALIA -Lt.scrotal swelling noted. (hydrocele).

Posterior tibia artery palpable

UPPER EXTREMITIES (right & left) -no defomity -ROM full -capillary refill <2sec

LOWER EXTREMITIES (right & left) -no defomity -ROM full -capillary refill <2sec

Dorsalis pedis ______________________________________________________________________________________________ artry palpable

PART 4

DIAGNOSIS

 Provisional Diagnosis: o Indirect Left Inguinal Hernia.  Differentials Diagnosis: o Strangulated Left Inguinal Hernia ______________________________________________________________________________

PART 5 5.1

BLOOD INVESTIGATIONS AND X-RAY FINDING

BLOOD UREA SERUM ELECTROLITE (BUSE) 

Blood Urea Nitrogen (BUN) o To measure how well the kidneys are working. Urea is a nitrogen-containing waste product that's created when the body breaks down protein. If the kidneys are not working properly, the levels of BUN will build up in the blood. Dehydration and excessive bleeding can also elevate the BUN levels in the blood.



Serum Electrolytes (SE)

o Typically, tests for electrolytes measure levels of sodium, potassium, chloride, and bicarbonate in the body. o Sodium (NA) plays a major role in regulating the amount of water in the body. Also, the age of sodium in and out of cells is necessary for many body functions, like transmitting electrical signals in the brain and in the muscles. The sodium levels are measured to detect whether there's the right balance of sodium and liquid in the blood to carry out those functions. o If a child becomes dehydrated because of vomiting, diarrhoea, or inadequate fluid intake, the sodium levels can be abnormally high or low, which can cause a child to feel confused, weak, and lethargic, and even to have seizures. o Potassium (K) is essential to regulate how the heart beats. Potassium levels that are too high or too low can increase the risk of an abnormal heartbeat. Low potassium levels are also associated with muscle weakness. o Chloride (CHLO), like sodium, helps maintain a balance of fluids in the body. If there's a large loss of chloride, the blood may become more acidic and prevent certain chemical reactions from occurring in the body that are necessary it to keep working properly. o Creatinine (CREAT) levels in the blood that are too high can indicate that the kidneys aren't working properly. The kidneys filter and excrete creatinine; if they're not functioning properly, creatinine can build up in the bloodstream. Both dehydration and muscle damage also can raise creatinine levels. Date : 13.05.200 9 Test NA K CHLO UREA| CREAT 

5.2

BUSE Result unit 138 mmol/L 3.3 mmol/L 99 mmol/L 4.1 mmol/L 75 umol/L Table 5.1 Patient’s BUSE Result

Interpretation: o All results are within normal range. FULL BLOOD COUNT (FBC)

Normal Range 135 -145 3.3 – 5.1 98 – 107 1.7 – 8.3 40 - 90

A full blood count (FBC) is a very common clinical procedure and often the “starting



point” for most medical investigations. An FBC not only tests for disorders and abnormalities of the blood but, as blood travels throughout the whole body, it can give an indication of disease present in other organs. Heamoglobin (Hb) o To determine any changes in patient’s heamoglobin such as low Hb so called



aneamia that indicates blood loss (internal or external) and Polycythaemia which is associated with an abnormally high haemoglobin concentration in the blood, and is an indication that red blood cell numbers are also too high. This could be due to respiratory or circulatory disorders or, in some cases, to a tumour. Sometimes a high red blood cell count is due to dehydration. 

Total White Cells (WBC) o To determine infection.



Platlet (PLT) o To evaluate the anti coagulation factor in the blood.

Date : 13.05.2009 (02.44pm) Test WBC RBC HGB PLT 

FULL BLOOD COUNT RESULT Result Unit Normal Range 3 8.67 10 / ul 4.0 – 10 5.85 106 / ul 4.04 – 6.13 17.4 g/dl 12.2 – 18.1 235 103 / ul 142 - 424 Table 5.2 Patient’s Full Blood Count Result

Interpretation: o All results are within normal range.

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PART 6 

REASON FOR DIAGNOSIS (Accroding To Patient History And Physical Examinations Finding) Patient history. o Left inguinal swelling for one year. o Once developed one episode of irreducible left inguinal on April 2009.



Physical examination. o Swelling of left inguinal region. o Reducible swelling with positive cough impulse.

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PART 7

TREATMENT & PRIMARY

EMERGENCY CARE 1. TRIAGING. 2. 3.

4.

5. 6.

7.

 Triaging was done and patient was sent to yellow zone. AIRWAY.  Airway not blocked. Patient can talk and was in pain. BREATHING.  Patient can breathing freely without difficulty.  Respiration: 20/minute. CIRCULATION.  Radial pulse present. 84 / minute.  Blood pressure: 130/80mmHg.  No obvious bleeding from the injury site or any part of the body. DISABILITY.  No neurological deficit noted. EXPOSURE  Swollen noted at left inguinal but reducible.  Left scrotal swelling due to hydrocele. INVESTIGATIONS.  Blood and X-ray investigation was not done in Emergency and Trauma Department.

8. PROCEDURES.  Swelling of the left inguinal hernia was reduce spontaneously. 9. MEDICATIONS.  IV Pethidine 50mg STAT was given because patient was in pain. 10. MONITORING  Vital signs Vital Signs

Result

Blood pressure

130/80 mmHg

Pulse

84/ minute

Temperature Respiration

37o C 20 / minute

SpO2

Table 7.1 Patient’s Vital Signs.

98%

11. PLANNING.  ission to Male Surgical for left inguinal hernia repair. __________________________________________________________________

PART 8

WAD MANAGEMENT AND PATIENT PROGRESSIONS

DAY ONE @ 13.05.2009 1. GENERAL CONDITION  Patient well and alert.  Taking orally well.  Ambulating well. 2. PHYSICAL EXAMINATION:  Lungs :

 

 Clear and equal air entry. CVS: DRNM Abdomen:  Soft.  Non tender.  Left inguinal hernia noted but reducible.  Cough impulse: positive.

3. PROCEDURE  No procedure done. 4. INVESTIGATION  Blood o Full blood count o BUSE o Creatinine o GSH o PT/PTT 5. MEDICATIONS  Not on any medication.

pending result.

6. MONITORING  Vital signs Vital Signs

Result

Blood pressure

140/90 mmHg

Pulse

80/ minute

Temperature

37o C

Respiration

20 / minute

SpO2

100%

Table 8.3 Patient’s Vital Signs. 7. PLANNING  Encourage orally.  To discuss with surgeon for further planning. _________________________________________________________________________

DAY TWO @ 14.05.2009 1. GENERAL CONDITION  Patient stable and comfortable.  Taking orally well. 2. PHYSICAL EXAMINATION:  Lungs :  Clear and equal air entry.

 

CVS: DRNM Abdomen:  Soft.  Non tender.  Left inguinal hernia noted but reducible.  Cough impulse: positive.

3. PROCEDURE -Seen by surgeon this morning. 

Left inguinal hernia repair tommorow. o Lapratomy Trans Abdominal Pre Peritoneal method (Lap. TAPP).

4. INVESTIGATION  Blood: Result refer to table 5.1 and 5.2. 5. MEDICATIONS  Not on medication. 6. MONITORING  Vital signs Vital Signs

Result

Blood pressure

130/80 mmHg

Pulse

86/ minute

Temperature

37o C

Respiration

18 / minute

SpO2

99% Table 8.4 Patient’s Vital Signs. 7. PLANNING  Nil by mouth at 12 midnight.  IVD 2.5 L/day (N/S alternate with D5%).

___________________________________________________________________________

DAY THREE @ 15.05.2009 1. GENERAL CONDITION  Patient stable and comfortable. 2. PHYSICAL EXAMINATION:



Lungs :  Clear and equal air entry.  CVS : DRNM  Abdomen:  Soft.  Non tender.  Left inguinal hernia noted but reducible.  Cough impulse: positive. 3. PROCEDURE  Received call from operation theatre to cancelled operation (lap.TAPP) due to congestion (OT was full). 4. MEDICATIONS o Not on medication. 5. MONITORING  Vital signs Vital Signs Result Blood pressure Pulse

100/70 mmHg 80/ minute

Temperature

37o C

Respiration

18 / minute

SpO2

99% Table 8.5 Patient’s Vital Signs. 6. PLANNING  Allow orally.  To arrange new OT date.

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FINAL DIAGNOSIS 1. LEFT INGUINAL HERNIA (INDIRECT). ___________________________________________________________ SUMMARY OF DISEASE INGUINAL HERNIA

DEFINITION Inguinal hernias occur when soft tissue usually part of the intestine protrudes through a weak point or tear in your lower abdominal wall. The resulting bulge can be painful especially when we cough, bend over or lift a heavy object. SYMPTOMS Some inguinal hernias don't cause any symptoms, and you may not know you have one until your doctor discovers it during a routine medical exam. Often, however, you can see and feel the bulge created by the protruding intestine. The bulge is usually more obvious when you stand upright, especially if you cough or strain. Inguinal hernia signs and symptoms include: 

A bulge in the area on either side of your pubic bone.



Pain or discomfort in your groin, especially when bending over, coughing or lifting .



A heavy or dragging sensation in your groin.

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Occasionally, in men, pain and swelling in the scrotum around the testicles when the protruding intestine descends into the scrotum.

SIGNS AND SYMPTOMS IN CHILDREN About five in every 100 children have inguinal hernias. Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia may be visible only when an infant is crying, coughing or straining during a bowel movement. In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period of time.

WHEN TO SEE A DOCTOR

See your doctor if you have a painful or noticeable bulge in the area on either side of your pubic bone. The bulge is likely to be more noticeable when you're standing upright, and you usually can feel it if you put your hand directly over the affected area. You should be able to gently and easily push the hernia back into your abdomen when you're lying down. If not, applying an ice pack to the area may reduce the swelling enough so that the hernia slides in easily. Lying with your pelvis higher than your head also may help.

If you still aren't able to push the hernia in, the herniated intestine may have become trapped (incarcerated) in the abdominal wall — a serious condition that may require immediate medical attention. This condition may be accompanied by nausea, vomiting or a fever, and a hernia bulge that turns red, purple or dark. If any of these signs or symptoms occur, call your doctor right away.

CAUSES Some inguinal hernias have no apparent cause. But many occur as a result of: 

Increased pressure within the abdomen



A pre-existing weak spot in the abdominal wall



A combination of the two In many people, the abdominal wall weakness that leads to an inguinal hernia occurs at birth when the abdominal lining (peritoneum) doesn't close properly. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to factors such as aging, strenuous physical activity or coughing that accompanies smoking. In men, the weak spot usually occurs along the inguinal canal. This is the area where the spermatic cord, which contains the vas deferens, the tube that carries sperm, enters the scrotum.

In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone.

MORE COMMON IN MEN

Men are more likely to have an inherent weakness along the inguinal canal because of the way males develop in the womb. In the male fetus, the testicles form within the abdomen and then move down the inguinal canal into the scrotum. Shortly after birth, the inguinal canal closes almost completely, leaving just enough room for the spermatic cord to through, but not large enough to allow the testicles to move back into the abdomen. Sometimes, however, the canal doesn't close properly, leaving a weakened area. There's less chance that the inguinal canal won't close after birth in female babies. In fact, women are more likely to develop hernias in the femoral canal, an opening near the inguinal canal where the femoral artery, vein and nerve through. Weaknesses can also occur in the abdominal wall later in life, especially after an injury or certain operations in the abdominal cavity.

Whether or not you have a pre-existing weakness, extra pressure in your abdomen can cause a hernia. This pressure may result from: 

Straining during bowel movements or urination



Heavy lifting



Fluid in the abdomen (ascites)



Pregnancy



Excess weight Even chronic coughing or sneezing can cause abdominal muscles to tear.

RISK FACTORS You're far more likely to develop an inguinal hernia if you're male. Nearly 10 times more men than women have inguinal hernias, and the vast majority of newborns and children with inguinal hernias are boys.

Other risk factors include: 

Family history. Your risk of inguinal hernia increases if you have a close relative, such as a parent or sibling, with the condition.



Certain medical conditions. Having cystic fibrosis, a life-threatening disorder that causes severe lung damage and often a chronic cough, makes it more likely you'll develop an inguinal hernia.



Chronic cough. A chronic cough, such as occurs from smoking, increases your risk of inguinal hernia.



Chronic constipation. This leads to straining during bowel movements — a common cause of inguinal hernias.



Excess weight. Being moderately to severely overweight can put extra pressure on your abdomen.



Pregnancy. This can both weaken the abdominal muscles and cause increased pressure inside your abdomen.



Certain occupations. Having a job that requires standing for long periods or doing heavy physical labor increases your risk of developing an inguinal hernia.



Premature birth. Infants who are born sooner than normal are more likely to have inguinal hernias.



History of hernias. If you've had one inguinal hernia, it's much more likely that you'll eventually develop another usually on the opposite side.

COMPLICATIONS Most inguinal hernias enlarge over time if they're not repaired surgically. Large hernias can put pressure on surrounding tissues in men they may extend into the scrotum, causing pain and swelling. But the most serious complication of an inguinal hernia occurs when a loop of intestine becomes trapped in the weak point in the abdominal wall (incarcerated hernia). This may obstruct the bowel, leading to severe pain, nausea, vomiting and the inability to have a bowel movement or gas.

It can also diminish blood flow to the trapped portion of the intestine a condition called strangulation that may lead to the death of the affected bowel tissues. A strangulated hernia is lifethreatening and requires immediate surgery.

TESTS AND DIAGNOSIS A physical exam is usually all that's needed to diagnose an inguinal hernia. Your doctor is likely to ask about your signs and symptoms and to check for a bulge in the groin area. Because coughing can make a hernia more prominent, you may be asked to cough or strain as part of the exam.

TREATMENTS AND DRUGS If your hernia is small and isn't bothering you, your doctor may recommend a watch-and-wait approach. But enlarging or painful hernias usually require surgical repair to relieve discomfort and prevent serious complications. There are two general types of hernia operations: 

Herniorrhaphy. In this procedure, your surgeon makes an incision in your groin and pushes the protruding intestine back into your abdomen, then repairs the weakened or torn muscle by sewing it together. After the operation, you'll be encouraged to move about as soon as possible, but it may be as long as four to six weeks before you're able to fully resume your normal activities.



Hernioplasty. In this procedure, which is something like patching a tire, your surgeon inserts a piece of synthetic mesh to cover the entire inguinal area, including all potential hernia openings. The patch is usually secured with sutures, clips or staples. Hernioplasty can be performed conventionally, with a single long incision over the hernia. But it's often done laparoscopically, using several small incisions rather than one large one. A fiber-optic tube with a tiny camera is inserted into your abdomen through one incision, and miniature instruments are inserted through the other incisions. Your surgeon then performs the operation using the video camera as a guide. Advantages of laparoscopic repair include less discomfort and scarring after surgery and a quicker return to normal activities — most people are back to work within a few days. The procedure is a good choice for people whose hernias recur following traditional hernia surgery because laparoscopic methods allow surgeons to work around scar tissue from earlier repair. It's also good for people who have hernias on both sides of the body (bilateral inguinal hernias). Disadvantages of laparoscopic repair include an increased risk of complications and of recurrence following surgery. These risks are reduced if the procedure is performed by a surgeon with extensive experience in these kinds of repairs.

You may not be a candidate for laparoscopic hernia repair if you have a very large hernia, if your intestine is pushed down into the scrotum or if you've had previous pelvic surgery such as a prostatectomy.

PREVENTION You can't prevent the congenital defect that may lead to an inguinal hernia, but the following steps can help reduce strain on your abdominal muscles and tissues: 

Maintain a healthy weight. If you think you may be overweight, talk to your doctor about the best exercise and diet plan for you.



Emphasize high-fiber foods. Fresh fruits and vegetables and whole grains are good for your overall health. They're also packed with fiber that can help prevent constipation and straining.



Lift heavy objects carefully or avoid heavy lifting altogether. If you have to lift something heavy, always bend from your knees, not from your waist.



Stop smoking. In addition to increasing your risk of serious diseases such as cancer, emphysema and heart disease, smoking often causes a chronic cough that can lead to or aggravate an inguinal hernia.



Don't rely on a truss for . Contrary to what you may have heard, wearing a truss isn't the best long-term solution for an inguinal hernia. A truss won't protect against complications

or correct the underlying problem, although your doctor may recommend wearing one for a short time before surgery. ______________________________________________________________________________________________