Hernia History

  • CC: most likely will present as a bulge:
    • Site: where?
    • Onset: first time? When did you first notice it? What were you doing? Sudden\gradual?
    • Progression: appears\disappears? Increasing in size? Reducible\irreducible?
    • Aggravating\relieving factors: Does is disappear when laying down, applying pressure on it? Does it become more apparent when coughing, straining, standing?
    • Overlaying skin: wounds, ulcers, discharge, bleeding
  • Associated sx:
    • Constitutional: fever, chills, wt loss, decreased appetite?
    • Obstruction: abdominal pain, distention, constipation, N\V
    • Strangulation: painful bulge, irreducible, red, tender
    • Predisposing factors: chronic cough, chronic constipation, straining when urinating\defecating

 

  • PMHx:
    • Diseases:
      • Chronic ds (HTN, DM, DLP)
      • Asthma
      • COPD
      • BPH
    • Medications
    • Surgery, hospitalization, trauma
    • Blood transfusions, IV drug use, tattoos
    • Allergies

 

  • FMHx:
    • Similar complaint?
    • Same diseases as in PMHx?
    • FHx of Marfan syndrome, Ehler-danlos syndrome?

 

  • Social Hx:
    • Occupation, marital status, children?
    • Smoking, alcohol, recreational drugs?
    • Travel Hx
    • Diet, exercise (weight lifting)

 


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