What is the diagnosis for a child with an irreducible firm swelling near the groin that becomes less firm when the child cries?

The diagnosis of an irreducible firm swelling near the groin that becomes less firm when the child cries is indicative of an inguinal hernia. An inguinal hernia occurs when a portion of intestine or fat protrudes through a weakness in the abdominal muscles into the inguinal canal. When a child cries, intra-abdominal pressure increases, which may reduce the firmness of the hernia by allowing better blood flow and shifting the contents, making it temporarily less tense. The irreducibility suggests that the hernia is likely incarcerated or possibly strangulated, which is a concern requiring prompt medical attention.

Other options present different clinical scenarios that do not match the features noted in this case. Testicular torsion typically presents with acute severe pain and swelling in the scrotum rather than a swelling in the groin. A hydrocele may present as a fluid-filled sac that can change in size but is usually reducible, and the firmness noted in the scenario does not align with this presentation. A femoral hernia also may present as a lump in the groin but is more likely to be seen in older children or females and typically does not exhibit the characteristic change in firmness associated with crying as described in the case of an ingu