General: Femoral Hernia

Question 1

Discuss the pathophysiology of a femoral hernia

Answer 1

Abdo viscera or omentum passes through the femoral ring and into the potential space of the femoral canal

Question 2

What are the risk factors for a femoral hernia?

Answer 2

Female

Increasing age

Pregnancy

Increased intra-abdo pressure = heavy lifting, chronic constipation

Question 3

How does a femoral hernia present?

Answer 3

Lump in the groin

Asymptomatic

Tightness of the ring means the hernia is unlikely to be reducible

Question 4

What is the gold standard investigation for a femoral hernia?

Answer 4

US

Question 5

What is the management for a femoral hernia?

Answer 5

Surgical = reduction of the hernia and then surgical narrowing of the femoral ring

Question 6

Name some possible complications from a femoral hernia

Answer 6

Strangulation

Irreducible

Obstructed

Question 7

How is it possible to differentiate between a femoral and inguinal hernia?

Answer 7

Location:

Femoral hernia = found infero-lateral to the pubic tubercle (and medial to the femoral pulse)

Inguinal hernia = found superomedial to the pubic tubercle

Question 8

How should a incarcerated/strangulated hernia be Mx?

Answer 8

NMB

Draining NG tube

IV fluids

Analgesia

Bloods + lactate

CTAP

Surgery