How niggly spluttering indicated the need for abdominal surgery

IT looked like the gentleman would need surgery – and all because of a niggly cough.

The middle-aged man had developed a cold which had spread to his chest, and the persistent coughing had bothered him for several weeks.

Then he’d noticed a swelling in his groin just at the bottom left area of the abdomen. He could push the wee lump back in from whence it came – only for it to reappear whenever he spluttered. Other than that there was a slight ache.

When I examined his groin I asked him to cough. You’ve probably seen this in movies where some plucky recruit joins the army and is examined by the medic.

Apparently it was standard procedure to check if the rookies had something called an inguinal hernia.

I suspected my patient had the same problem – and when he coughed I could indeed feel a little lump pushing out.

An inguinal hernia is where a little bit of tissue from the intestines pushes through the wall of the abdomen and bulges outwards.

As a baby boy develops in the womb, the testicles descend through a tunnel in the groin, into the scrotum, but that tunnel can later become the weak area through which the intestines push.

Sometimes a hernia just appears, while other times it may start after lifting, straining on the toilet or coughing. Obesity can increase the risk too and may also make a hernia harder to spot.

To repair them, a mesh is surgically inserted which gradually integrates with the muscle.

There’s a small chance that a hernia, left too long, may strangulate – which is as unpleasant as it sounds and requires emergency surgery.

Untreated inguinal hernias are also inclined to get bigger and more uncomfortable – so we generally operate to repair them nowadays.