Offensive, Defensive Medicine

Case: 54 year old male with intermittent bulge to right inguinal area accompanied with intermittent,  sharp pain.

Class? Diagnosis? Treatment?

Class, how should this be diagnosed?

Reality. Internist has an idea... does KUB.... it may show a nephrolith. Internist prescribes antibiotics and steroids. Refers Urology.

Urology is not sure.... orders CT scan. CT does not show stone.

Patient sent home. Still in pain. A week later goes back to internist with picture of said 'bulge'. Internist has more clear idea. Refers to General Surgeon #1. General surgeon #1 thinks he knows. Refers to General surgeon #2 who disagrees with General surgeon #1 but agrees to operate anyway. Is surprised there is a CT Scan that has been done. Inquires as to results of scan. They are negative. He operates anyway and discovers, three weeks into course of illnesss...

Class?

And what did we learn?