<prompt> A 15-year male presented with pain in the inguinal area and lower abdomen presents with tenderness over a non-reducible swellingwith negative cough impulse. Diagnosis:Strangulated herniaTesticular torsionScrotal abscessFemoral hernia  <response>: 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 herniaIndirect 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 HerniaSudden onset inguinal painGeneralized abdomen painTense and extremely tender herniaDiscolouration of overlying skin with a reddish or bluish tingeThere is no expansile cough impulse. 