UNIVERSITY OF SOUTHERN PHILIPPINES FOUNDATION

Salinas Drive, Lahug, Cebu City

COLLEGE OF NURSING

CASE STUDY

PATIENT PROFILE:

• Name: Jonel Capuyan

• Age: 5y2m19d

• Sex: male

• Status: child

• Address: Poblacion, Carmen, Cebu

• Name of Hospital: Vicente Sotto Memorial Medical Center

• Date of Admission: Aug. 23, 2009

• Ward & Bed No. : Ward VI/ Bed no. PS4

• Case No. : 65538

• Chief Complaint: pain at the lower left inguinal

• Medical diagnosis: Hernia, Inguinal Indirect left meducible

- An indirect inguinal hernia is an inguinal hernia that

results from the failure of embryonic closure of the internal inguinal ring after the
testicle has passed through it. Like other inguinal hernias, it protrudes through
the inguinal ring. It is the most common cause of groin hernia.

History of Past Illness:

Patient delivered full term, normal spontaneous vaginal delivery, home

delivery by Trained Barangay Assistant, BCG, DPT, OPV, (-) Hepa, (-) meales.

History of Present Illness:

Condition noted immediately after birth, patient 7 months old

recommended surgery aonsult at the Local Health Center, consult for obstructive
prevention of condition with accompanied pain prompted patient’s mother and
sought consult.
Genogram:

Cecilio Anita
Lourdes Antonio
Cole Capuyan
Cole (DM) Capuyan
(HPN,
Hernia)
 Judelyn Ranilo
Cole Capuyan

Mariann Jonel
Vincent
e (Hernia)

Male Female

Diagnostic test and Laboratory:

 CBC Result

Exam Result Normal value

RBC 5.03 4.20-5.40 ml/mn

Hemoglobin 0.426 0.37-0.47 L/L

MCV 85 81.00-99.00 gl

MCM 28 27.00-31.00 pg

WBC 9.2 4.80-10.80 10^g/L

MCHC 332 330.00-370.00 fl

RDW 10.3 11.00-16.00 fl

MPV 7.3 7.20-11.10 fl

Platelet count 444 150.00-400.00 10^g/L

Neutrophil 41.2 40.00-74.00 %

Lymphocyte 35.8 19.00-48.00 %

Monocyte 8.4 3.40-9.00 %

Eosinophil 13.5 0.00-7.00 %

Basophil 1.1 0.00-1.50 %

Blood type: A+

Urinalysis

Color: yellow RBC cells: 0-1/hpf

Transparency: clear Pus cells: 0-2/hpf

Reaction: 6.0

Specific Gravity: 1.030

Sugar: negative

Protein: negative

Abnormal crystals: Normal crystals:

Tyrosine: Calcium oxalate:

Cystine: Amorphous Urates: few

Leucine: Uric acid:

Ultrasound

Scrotal area

Findings:

The right testicle measures 1.5x0.8x0.7cm while the left testicleis displaced
inferomedially and measures 1.8x0.5x0.7cm. both exhibit a homogeneous echo
pattern. There are loops of bowels with peristalsis noted within the scrptal sac.

Conclusion:

Scrotal hernia

Normal size and appearance of both testicles.

Pathophysiology:

Host: Etiology:

Males 90% -congenital

-heredofamilial
 Canal begins in the intraabdominal cavity at the internal ring

(located lateral to the inferior epigastric arteries, approximately midway

between the pubic symphysis and anterior iliac spine)

canal courses down along the inguinal ligament.

External ring of the canal is located medial to the inferior

epigastric arteries, subcutaneously and slightly above

the pubic tubercle.

Contents of this hernia then follow the tract of the testicle down into the

scrotal sac.

Signs & Symptoms:

Textbook-based Patient’s Manifestation Interpretation

-aymptomatic

-lump or swelling in the

groin

-a sudden pain into the

scrotum

-abdominal discomfort

-heavy feeling in the groin

-pain in the groin while

standing or moving