Femoral Hernia – Causes, Symptoms & Treatment
A femoral hernia is a type of hernia in which abdominal tissue protrudes through the femoral canal, below the inguinal ligament. It occurs more often in women.
Things worth knowing about "Femoral Hernia"
A femoral hernia is a type of hernia in which abdominal tissue protrudes through the femoral canal, below the inguinal ligament. It occurs more often in women.
What Is a Femoral Hernia?
A femoral hernia (also called a crural hernia) is a condition in which a portion of abdominal tissue -- such as a loop of intestine or fatty tissue -- pushes through the femoral canal, a small passage located just below the inguinal (groin) ligament on the inner thigh. Unlike the more common inguinal hernia, a femoral hernia sits below the inguinal ligament. It is more frequently seen in women, likely due to the wider anatomical structure of the female pelvis and femoral canal.
Causes
Femoral hernias develop when increased pressure in the abdomen forces tissue through a weak point in the abdominal wall near the femoral canal. Contributing factors include:
- Chronic straining due to persistent cough, constipation, or heavy lifting
- Pregnancy, which increases intra-abdominal pressure over time
- Connective tissue weakness, which may be inherited or develop with age
- Obesity, which places ongoing stress on the abdominal wall
- Aging, which is associated with a gradual weakening of supporting tissues
Symptoms
Many femoral hernias are initially asymptomatic and discovered incidentally. When symptoms are present, they may include:
- A visible or palpable bulge in the groin or upper inner thigh area
- Dull or aching discomfort in the groin, particularly during physical activity
- In cases of incarceration (trapped hernia): sudden severe pain, nausea, vomiting, and signs of bowel obstruction -- this constitutes a medical emergency
Diagnosis
Diagnosis is primarily based on a thorough physical examination of the groin and femoral region. Imaging studies may be used to confirm the diagnosis or plan treatment:
- Ultrasound: A quick, radiation-free method to visualize the hernia and its contents
- MRI or CT scan: Used in unclear cases or for detailed preoperative planning
Distinguishing a femoral hernia from the more common inguinal hernia is important, as their anatomical locations differ and surgical approaches may vary accordingly.
Treatment
Due to the relatively high risk of incarceration associated with femoral hernias, surgical repair is generally recommended even in the absence of significant symptoms.
Surgical Options
- Open surgery: A direct incision is made in the groin area to close the hernia defect, often reinforced with a synthetic mesh
- Laparoscopic (minimally invasive) surgery: The repair is performed through small incisions using a camera and instruments; associated with faster recovery and less postoperative pain (e.g., TAPP or TEP techniques)
Emergency Treatment
An incarcerated femoral hernia requires immediate surgical intervention to prevent ischemia (loss of blood supply) and potential necrosis of the trapped bowel segment.
References
- Simons MP et al. - European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13(4):343-403.
- Miserez M et al. - Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal and femoral hernia in adult patients. Hernia. 2014;18(2):151-163.
- Townsend CM et al. - Sabiston Textbook of Surgery. 21st edition. Elsevier, Philadelphia 2022.
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