February 26, 1997

A 65-Year-Old Man With an Inguinal Hernia

JAMA. 1997;277(8):663-669. doi:10.1001/jama.1997.03540320065037

Dr DELBANCO:  Mr K, a 65-year-old engineer and married father of 6, has had a moderate-sized hernia for many years and is trying to decide whether to have it repaired. Recently retired from his principal job but still working full-time, he is covered by Medicare and supplementary private insurance. He lives in a suburb of Boston, Mass, and for several years has been cared for by Dr M, a general internist practicing in a primary care unit at the Beth Israel Deaconess Medical Center.Mr K was born with a left-sided hernia. He recalls having episodes of pain as a young child and that he and his family attempted periodically to reduce the hernia. When he was 8 years old, the hernia was repaired. He has had no trouble on that side since. In 1961, he was first told of a hernia on the right side during a routine military