This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
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: 
Select and explain. 
A. Strangulated hernia, B. Testicular torsion, C. Scrotal abscess, D. Femoral hernia
A: Strangulated hernia
Answer: A: Strangulated hernia 
Explanation: 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.