Femoral hernia Flashcards
What is the definition of a femoral hernia?
Protrusion of abdominal organ through weak muscles of the abdominal wall into the femoral canal
How common are femoral hernias?
Uncommon – account for 2% of all hernias
What is the pathology of femoral hernias?
• Intestines/fatty tissue pushes through the femoral ring in the wall of the femoral canal (defected transversalis fascia)
What are the risk factors/aetiology of femoral hernias?
- Female – due to wider pelvis, making femoral canal wider
- Pregnancy - ↑ intra-abdominal pressure, laxity of tissue
- Chronic cough - ↑ intra-abdominal pressure
- GI obstruction - ↑ intra-abdominal pressure
- Excessive straining e.g. lifting heavy weights - ↑ intra-abdominal pressure
- Rapid weight loss – laxity of tissues
- Previous inguinal/femoral hernia repair – laxity of tissue
- Age – older = more likely
- Obesity – may be a link
What are the signs/symptoms of femoral hernias?
- Painful lump lateral and inferior to the public tubercle
- Lump cam be pushed back in/disappear when lying down
- Coughing/straining may make the lump appear
- If lump hard/tender = strangulation
- Nausea/vomiting = strangulation
- Place finger over femoral canal (palpate the femoral artery, it is one finger length medial, below the inguinal ligament) – when patient coughs a femoral hernia remains reduced and inguinal hernia reappears as a swelling
What diseases can femoral hernias present similarly to?
- Inguinal hernia
- Hydrocele
- Ectopic testes
- Lymph node swelling
- Psoas abscess/bursa
- Lipoma
- Bleeding
What investigations are carried out when a femoral hernia is suspected?
- US
- CT
- MRI
What are the surgical treatment of a femoral hernia?
- Laparoscopy femoral hernia repair
* Open surgery femoral hernia repair
What are the pharmacological treatment of a femoral hernia?
none
What are the non pharmacological treatment of a femoral hernia?
• High fibre diet – to avoid constipation