What is a Femoral Hernia?
Femoral hernia is a form of hernia that occurs in the upper thigh or lower groin. It is observed at a higher frequency in women (70%) due to anatomical variation compared to men (larger pelvic diameter). In the majority of cases, femoral hernia is discovered due to exceptionally severe symptoms, as its size usually does not exceed 1 cm, making it difficult to recognize, especially in overweight people.
Anatomical location of femoral hernia
Femoral hernia occurs anatomically as a lump in the groin or thigh. It projects into the femoral ring, a small channel located under the inguinal ligament. The femoral canal hosts the femoral artery, vein and nerve. The swelling created by the femoral hernia is located just below the inguinal ligament, and although it differs from the inguinal hernia, often these two forms of hernia are confused due to their anatomical proximity.
Predisposing factors for development of femoral hernia
Important factors that can lead to the appearance of femoral hernia are:
- obesity
- chronic constipation
- pregnancy
- regular or abrupt lifting of significant weight
- chronic obstructive pulmonary disease
- genetic predisposition
Symptoms of femoral hernia
Having a femoral hernia can cause severe symptoms. One of the main symptoms of femoral hernia is the appearance of a small bulge high in the thigh, which develops gradually. This swelling is observed mainly in an upright position, but also during physical exertion. Femoral hernia becomes even more noticeable during a strong cough. There is also mild discomfort in the femoral groin area that becomes more intense when intra-abdominal pressure increases.
Common complications of femoral hernia
Very often the condition is manifested by complications, such as incarceration. In such cases, immediate medical intervention is required, as the contents of the hernia (almost always the small intestine) are trapped and endangered due to ischemia, in the narrow orifice of the hernia. Severe pain occurs in the area, redness and swelling, and then symptoms of obstruction of the small intestine (bloated abdomen and vomiting) develop.
Incarceration is a condition that, if not treated, will lead to ischemia and necrosis of the trapped viscera. It is accompanied by severe pain in the thigh groin, nausea and vomiting. According to the British Hernia Center, it is estimated that in case of incarceration the intestine can survive about 8 to 12 hours and requires immediate surgery.
How is a femoral hernia diagnosed?
For the diagnosis of femoral hernia, a detailed clinical examination is required to identify (palpate) the swelling in the thigh groin. Often, especially in obese people, femoral hernia is difficult to distinguish from inguinal hernia. In cases where distinguishing between the two types of hernia is difficult, imaging tests are performed, such as ultrasound and CT scan.
How is a femoral hernia treated?
As in any form of hernia, but more imperative in the case of femoral hernia, immediate surgical intervention is necessary in all patients, as the likelihood of complications -the most important of which is incarceration- is particularly high.
