On clinical examination pay special attention to;
On clinical examination, note the important points outlined above. Evidence of a complicated obstruction would include; an unwell patient, tachycardia, hypotension, pyrexia, severe dehydration, abdominal tenderness and a leucocytosis. Such findings should accelerate the decision to proceed with surgery.
It is foolish to embark on a laparotomy if the patient has obstruction from an obvious femoral hernia. The patient may be best served by an approach directly to the hernia. So, check the hernial orifices.