A 70-year-old woman presents with a tender irreducible mass immediately below and lateral to the pubic tubercle. Plain abdominal x-ray shows intestinal obstruction Treatment with a nasogastric tube and intravenous fluids is initiated. What is the next step in treatment?

This patient has a strangulated femoral hernia. Emergency surgery after appropriate resuscitation is the correct treatment. Gangrene of strangulated bowel may be present. No attempt at manual reduction should be made because gangrenous bowel may be returned to the peritoneal cavity.