Abstract
A femoral hernia is protrusion of a segment of intestine or other parts of the abdominal contents through a channel called the "femoral canal" - a tube-shaped passage at the top of the front of the thigh. The femoral canal, into which a femoral hernia is squeezed and stuck, lies adjacent to the point where the blood vessels and nerves pass from the abdomen into the leg. It presents a potential weak spot in the abdominal wall. If the hernia can be manually pushed back into the abdomen it is referred to as "reducible". However, usually this is not possible and the hernia is effectively stuck in the canal. This is an "irreducible" hernia and leads to a potentially dangerous condition. The blood vessels in the herniated tissue may become crushed within the canal, cutting off its supply of oxygen and nutrients. This is known as strangulated hernia and emergency surgery must be performed to release the trapped tissue and restore its bloody supply. A truss should not be used for a femoral hernia as it can encourage the hernia to become strangulated. Treatment is an immediate surgical intervention to return the herniated intestine to its proper place and to close the weak point in the abdominal wall.
References
1. Kingsnorth A, Bennet DH. Russell RCG, Williams NS, Bulstrode CJK, editors. Hernias, umbilicus, abdominal wall. Bailey and Love's short practice of surgery. 2000. 62:23rd ed. London: Arnold;1143–1162. .
2. Amid PK, Shulman AG, Lichtenstein IL. The femoral canal: the key to femoral herniorrhaphy. Int Surg. 1990. 75:69–72.
3. Mathonnet M, Mehinto D. Femoral hernias: repair techniques. J Chir (Paris). 2007. 144:5S15–5S18.
5. Stagnitti F, Toccaceli S, Spaziani E, Casciano EG, Priore F, Gammardella P, et al. The femoral hernia: problems in emergency surgery. G Chir. 2006. 27:290–294.
7. Maingot R. The choice of operation for femoral hernia, with special reference to McVay's technique. Br J Clin Pract. 1968. 22:323–329.
8. Shahzad F, Bowen-Pasfield S, Vaughan R, Kumar T. Pediatric femoral hernias: a case report and review of the literature. W V Med J. 2008. 104:10–11.
9. Koch A, Edwards A, Haapaniemi S, Nordin P, Kald A. Prospective evaluation of 6895 groin repairs in women. Br J Surg. 2005. 92:1553–1558.
10. Fitzgibbons RJ Jr, Filipi CJ, Quinn TH. Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, editors. Inguinal hernia in Schwartz's principles of surgery. 2005. 36:8th ed. New York: Mc Graw-Hill Co;1353–1394.
11. Rahaman QM, Goswami B, Gumta MK, Samanta S, Mukhopadhyay S, Chattopadhyay M. Bilateral femoral hernia in male-a case report. J Indian Med Assoc. 2005. 103:237.
12. Rosenblatt GS, Para R, Conlin MJ. Exacerbation of occult femoral hernia during laparoscopic prostatectomy. JSLS. 2005. 9:476–477.
13. Moon SK, Lee GS, Lee ES, Kang HM, Lee JH, Kim JS, et al. A case of intestinal obstruction caused by strangulated femoral hernia accompanying soft tissue necrosis. Korean J Gastroenterol. 2007. 50:340–343.
14. D'Ambrosio N, Katz D, Hines J. Perforated appendix within a femoral hernia. Am J Roentgenol. 2006. 186:906–907.
15. Sharma H, Jha PK, Shekhawat NS, Memon B, Memon MA. De Garengeot hernia: an analysis of our experience. Hernia. 2007. 11:235–238.
16. Hosaka A, Masaki Y, Yamasaki K, Aoki F, Sugizaki K. Pseudomyxoma peritonei presenting with femoral hernias and peritonitis. J Gastrointest Surg. 2007. 11:1576–1578.
17. Zacharakis E, Papadopoulos V, Athanasiou T, Ziprin P, Zacharakis E. An unusual presentation of Meckel diverticulum as strangulated femoral hernia. South Med J. 2008. 101:96–98.
18. Mirza MS. Incarcerated Littre's femoral hernia: case report and review of the literature. J Ayub Med Coll Abbottabad. 2007. 19:60–61.
19. Natsis K, Apostolidis S, Papadopoulou AL, Vlasis K, Totlis T, Skandalakis P. Gastric femoral hernia in a male cadaver with gastroptosis: case report and review of the literature. Hernia. 2008. 12:205–208.
20. van den Berg JC, de Valois JC, Go PM, Rosenbusch G. Detection of groin hernia with physical examination ultrasound, and MRI compared with laparoscopic findings. Invest Radiol. 1999. 34:739–743.
21. Robinson P, Hensor E, Lansdown MJ, Ambrose NS, Chapman AH. Inguinofemoral hernia: accuracy of sonography in patients with indeterminate clinical features. Am J Roentgenol. 2006. 187:1168–1178.
22. Suzuki S, Furui S, Okinaga K, Sakamoto T, Murata J, Furukawa A, et al. Differentiation of femoral versus inguinal hernia: CT findings. Am J Roentgenol. 2007. 189.
23. Cherian PT, Parnell AP. The diagnosis and classification of inguinal and femoral hernia on multisection spiral CT. Clin Radiol. 2008. 63:184–192.
24. Alimoglu O, Kaya B, Okan I, Dasiran F, Guzey D, Bas G, et al. Femoral hernia: a review of 83 cases. Hernia. 2006. 10:70–73.
25. Nilsson H, Stylianidis G, Haapamäki M, Nilsson E, Nordin P. Mortality after groin hernia surgery. Ann Surg. 2007. 245:656–660.
26. Suppiah A, Gatt M, Barandiaran J, Heng MS, Perry EP. Outcomes of emergency and elective femoral hernia surgery in four district general hospitals: a 4-year study. Hernia. 2007. 11:509–512.
27. Zdravković D, Masirević R, Bilanović D, Mastrević V, Zdravković M, Milinić N. Acute appendicitis in a femoral hernia. Med Pregl. 2007. 60:85–87.
28. Ceriani V, Faleschini E, Sarli D, Lodi T, Roncaglia O, Bignami P, et al. Femoral hernia repair. Kugel retroparietal approach versus plug alloplasty: a prospective study. Hernia. 2006. 10:169–174.
29. Williams GL, Riddell A, Coulston J, Frost B, Stephenson BM. Prosthetic repair of prevascular femoral herniation. Hernia. 2007. 11:513–515.
30. Bátorfi J. The treatment of inguinofemoral hernias with laparoscopic herniorrhaphy. Our experience of 1210 transabdominal preperitoneal (TAPP) reconstructions. Magy Seb. 2005. 58:385–397.
31. Fitzgibbons RJ Jr, Camps J, Cornet DA, Nguyen NX, Litke BS, Annibali R, et al. Laparoscopic inguinal herniorrhaphy. Results of a multicenter trial. Ann Surg. 1995. 221:3–13.
32. Yalamarthi S, Kumar S, Stapleton E, Nixon SJ. Laparoscopic totally extraperitoneal mesh repair for femoral hernia. J Laparoendosc Adv Surg Tech A. 2004. 14:358–361.
33. Glassow F. Femoral hernia following inguinal herniorrhaphy. Can J Surg. 1970. 13:27–30.