Femoral Hernias

Question 1

Define

Answer 1

Bowel enters femoral canal
→ Appears below and lateral to pubic tubercle medial to femoral pulse

Likely to be irreducible and to ↑risk of strangulation due to rigidity of canal’s borders (bony/ligamentous structures on three sides)

Question 2

Causes

Answer 2

↑intra-abdomen pressure with pressure on the weakened area (enlarge prostate, pregnancy, frequent cough, chronic constipation, intense workouts)

Question 3

Risk Factors

Answer 3

(increase pressure)→ obesity, chronic cough, enlarge prostate, elderly, congenital weakening

Question 4

Epidemiology

Answer 4

Much rarer than inguinal (only about 5% of all abdomen hernias) Occur more often in women (especially middle aged and elderly) due to ↑space to allow femoral vein to increase in size for gynae reasons

Question 5

Symptoms

Answer 5

• Presents as a mass in the upper medial thigh or above the inguinal ligament where it points down to the leg (unlike inguinal which points to the groin)
• May see lower abdomen pain if incarceration occurs

Question 6

Signs

Answer 6

• May be a cough impulse
• Hernia appears/swells on coughing/staining
• Hernia reduces on relaxation/lying supine