Femoral hernia in adults

Femoral hernia is quite rare and is most often recorded in women. Femoral hernias are found in the groin and may appear as a painful bump on the inner thigh. The bump may periodically subside, and sometimes becomes more noticeable when straining or coughing. Surgeons estimate that only 1 in 20 inguinal hernias are true femoral hernias, and the majority are atypical inguinal hernias. They are more common in women because women have a wider pelvis and there are peculiarities in the structure of tissues.

A femoral hernia occurs in the inguinal fold when tissues in the lower abdomen are forced out through the upper thigh. A femoral hernia is common in women and extremely rare in men because the pelvis is wider in women. The femoral canal contains ligaments and connective tissue to keep the uterus in position. Men do not have similar ligaments, and therefore hernias are extremely rare.

Recognition of a femoral hernia is an important factor in the evaluation and evaluation of a patient with a groin bulge, as treatment options and urgency may differ from those for more advanced inguinal hernia.

What is a femoral hernia

A hernia is defined as an abnormal protrusion of a part of an organ or tissue through a defect in its surrounding tissues (usually skin, fascia and muscles, aponeuroses). Hernia defects can occur in various places of the abdominal wall, but most often in the groin. Hernias can occur in areas where the aponeurosis and fascia (thin films of connective tissue) are not covered by striated muscles. As a result, the abdominal wall or hernial sac may protrude from the orifice or neck of the hernia.

Symptoms of a femoral hernia in adults

Often, a hernia looks like a rounded bulge in the groin or upper thigh, ranging in size from a pea to a hen’s egg or more. However, some people with a femoral hernia do not notice any bulge, lump, or pain. But large, complicated femoral hernias cause a noticeable bulge in the upper thigh that can be painful, especially when exerting, lifting, or moving.

Symptoms of strangulated femoral hernia:

• sudden pain in the groin and abdomen;
• nausea;
• vomiting.

Causes of femoral hernia in adults

A femoral hernia is the result of an outflow of fatty tissue or part of the intestine into the groin on the inside of the thigh. The area where the protrusion can occur is called the femoral canal, it is considered a weak point in the muscles of the abdominal wall. Actual causes of femoral hernia:

• Weightlifting;
• tension in the toilet;
• obesity;
• persistent severe cough;
• childbirth.

A femoral hernia is a characteristic bulge under the inguinal ligament. Incarceration is the most common serious complication of femoral hernia – these hernias have the highest rate of incarceration (15% to 20%).

The incidence of inguinal hernia is 27% to 43% in men and 3% to 6% in women. Femoral hernias are less common than inguinal hernias and usually account for about 3% of all hernias in the groin area. Moreover, femoral hernias have a female to male ratio of approximately 10:1.

Other associated defects may be present at the time of diagnosis, as 10% of women and 50% of men with a femoral hernia either have an inguinal hernia or will soon develop one.

The prevalence of femoral hernia increases with age, as does the risk of complications, including nonreducible hernia or strangulation. Both femoral and inguinal hernias are more likely to occur on the right side. This is probably due to the peculiarities of the position of the sigmoid colon. It closes the passage of the left femoral canal, reducing the likelihood of a left-sided defect.

Treatment of femoral hernia in adults

A femoral hernia causes pain in the abdomen. The doctor suggests various tests to diagnose its presence, including an ultrasound scan or a CT scan.

Diagnostics

A femoral hernia may be detected during a routine physical examination, and about one-third of patients may be asymptomatic at the time of diagnosis. There is usually a slight bulge below the level of the inguinal ligament. It can decrease with direct pressure or manipulation.

A doctor will suspect a femoral hernia when examining a patient with a bulge or painful mass in the groin area. If possible, the physical examination should be performed in both the supine and standing positions. A visual inspection should be performed for asymmetries, bulges, or inhomogeneous masses.

Imaging studies, including ultrasound or computed tomography (CT), can be used to evaluate possible complications of a hernia. Both studies offer a high degree of both sensitivity and specificity in the detection of femoral and inguinal hernias. This provides a better assessment in severely obese patients who are difficult to detect on physical examination.

Modern treatments

Surgery is considered the only effective treatment. With regard to the timing of intervention or repair of a femoral hernia, in case of infringement or obstruction of the intestine, urgent surgical intervention is performed, and surgical intervention should not be postponed.

Femoral hernias can be treated using a standard inguinal approach, open surgery, or minimally invasive (laparoscopic or robotic laparoscopic) intervention. Regardless of the technique or approach, the key steps in femoral hernia repair include incision and reduction of the hernial sac, and closure of the defect with prosthetic mesh placement.

Prevention of femoral hernia in adults at home

In most cases, femoral hernia repair gives excellent results. The overall recurrence rate for inguinal hernias ranges from 5% to 10%. Usually it is associated with a violation of the rules of rehabilitation and non-compliance with recommendations for the prevention of complications.

In order to avoid the formation of a hernia, you need to monitor nutrition, avoid constipation, give up heavy physical exertion and weight lifting, weightlifting.

Popular questions and answers

We asked questions about inguinal hernias and their causes, symptoms to the therapist, gastroenterologist of the State Healthcare Institution of Public Health Clinic No. 30 in Volgograd, Vera Samsonova.