An 88yo woman is a known smoker. She had an attack of MI 2y back and is known to have peripheral vascular disease. She presents with an irreducible herniation over the incision region of a surgery which she underwent in her childhood. What is the most appropriate tx?
a. Truss
b. Elective herniorrhaphy
c. Urgent herniorrhaphy
d. Elective herniotomy
e. Reassure
Ans. The key is B. Elective hernioraphy. [Truss can not be used as hernia is irreducible; urgent herniorrhaphy in strangulation; elective herniotomy- in herniotomy the hernia will not subside or recur; only reassure is not an option as irreducibe hernia may become strangulated or may develop intestinal obstruction