A male child with swelling in the upper left thigh below the inguinal ligament complains of cramping and abdominal pain. What should be in the differential diagnosis?

In this scenario, the symptoms of swelling in the upper left thigh, along with complaints of cramping and abdominal pain, suggest that a femoral hernia should be included in the differential diagnosis. A femoral hernia typically presents with a bulge in the groin area that can cause discomfort, particularly during activities that increase intra-abdominal pressure, such as cramping or straining. The location of the swelling being below the inguinal ligament further supports this diagnosis since femoral hernias occur below the inguinal ligament as opposed to inguinal hernias, which are located above it.

Additionally, the demographic of a male child experiencing these symptoms aligns with typical presentations of hernias in pediatric cases. It's important to differentiate this from conditions like inguinal hernias or other abdominal pathologies based on the specific location of the swelling and the nature of the pain. Thus, a femoral hernia is particularly relevant to consider given the clinical presentation observed in this young male patient.