A 62-Year-Old Man Comes to the Physician Due to Intermittent

A 62-year-old man comes to the physician due to intermittent groin pain.  The pain is most severe when the patient lifts heavy loads and after a long day at his job as a construction worker.  Physical examination shows a right-sided groin bulge directly above the inguinal ligament.  The bulge increases in size when he bears down.  An ultrasound reveals that the mass originates medial to the inferior epigastric vessels.  This patient's condition is most likely caused by which of the following?

A) Failure of the internal inguinal ring to close
B) Patent processus vaginalis
C) Separation of the abdominal muscles
D) Weakness of the transversalis fascia
E) Widening of the femoral ring

Correct Answer:

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