This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Inguinal Hernias, Subject name: Surgery
A 15 year male presented with pain in inguinal area and lower abdomen presents with tenderness over a non-reducible swelling with negative cough impulse. Diagnosis: 
Select and explain. 
A. Strangulated hernia, B. Testicular torsion, C. Scrotal abscess, D. Femoral hernia
A: Strangulated hernia
Answer: A: Strangulated hernia 
Explanation: Ans. (a) Strangulated herniaRef: Sabistan 19th ed. /1127* 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 > OmentumClinical features of strangulated inguinal Hernia* Sudden onset inguinal pain* Generalized abdomen pain* Tense and extremely tender hernia* Discoloration of overlying skin with a reddish or bluish tinge* There is no expansile cough impulse.