Femoral Hernia Flashcards
What is a femoral hernia?
When abd viscera / omentum push through into femoral canal via femoral ring
What are the risk factors for femoral hernias? (4 things)
- Age
- Female
- Pregnancy
- Raised intra-abd pressure (chronic constipation / coughing / heavy lifting)
What are the clinical features of femoral hernias? (2 things)
- Asymptomatic (apart from lump)
- Often irreducible (bc tightness of femoral ring)
What are other differentials that present similarly (lump) to femoral hernias? (3 things)
- Inguinal hernia
- Femoral canal lipoma / lymph node
- Femoral artery aneurysm
How can a femoral hernia be diagnosed?
Often clinically
What imaging may be used for femoral hernia diagnosis? (2 things)
- US
- CT abdomen-pelvis
If you are uncertain about the diagnosis or presence of complications of a femoral hernia what should you do?
Surgically explore
How do you manage femoral hernias?
Surgery
What does surgical management of femoral hernias include? (2 things)
- Reduce hernia
- Narrow femoral ring w sutures / mesh plug
Within how many weeks should surgical management of femoral hernias be done?
Why?
Within 2 weeks
High risk of strangulation
What are the 2 approaches for surgical management of femoral hernias?
- Low approach (incision BELOW inguinal canal)
- High approach (incision ABOVE inguinal canal)
What are the pros and cons of the Low Approach surgical management of femoral hernias?
Pros: doesn’t intervene w inguinal structures
Cons: limited space for removal of any compromised bowel
What approach (low or high) is preferred for surgical management of femoral hernias in EMERGENCIES?
Why?
High approach
Bc easier access to compromised small bowel
What are the complications of femoral hernias? (2 things)
- Strangulation (compromised vasc supply –> bowel ischaemia)
- Bowel obstruction
