A 15-year male presented with pain in the inguinal area and lower abdomen presents with tenderness over a non-reducible swelling with negative cough impulse. Diagnosis:

Strangulation occurs more often in patients who have worn a truss for a long time and in those with a partially reducible or an irreducible hernia Indirect inguinal hernias strangulate more commonly, the direct variety not so often because of the wide neck of the sac. MC constricting agent: Neck of the sac > External inguinal ring in children > Adhesions within the sac. MC contents: Small intestine > Omentum Clinical features of strangulated inguinal Hernia Sudden onset inguinal pain Generalized abdomen pain Tense and extremely tender hernia Discolouration of overlying skin with a reddish or bluish tinge There is no expansile cough impulse.