English: :46 yo healthy male presents with slowly worsening left groin pain. The patient works in manual labor. On exam he is in mild distress and points to an area just lateral to his pubic symphysis, stating that he has an aching pain in that region that is worse as the day progresses. On physical exam, the vitals are normal except for mild tachycardia. No obvious bulge, swelling or skin changes seen over the area, and palpation does not elicit any obvious findings of a hernia, however suspicion still remains high. An ultrasound is brought into the room revealing the following images:

File:UOTW 40 - Ultrasound of the Week 4.jpg