<prompt> 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:Strangulated herniaTesticular torsionScrotal abscessFemoral hernia  <response>: 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. 