Femoral hernia – Causes, symptoms and treatment

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Continuing our spotlight on different types of hernias, today we focus on femoral hernia which occurs more frequently in women.

Femoral herniaWhat is femoral hernia?

A femoral hernia is a bulge of tissue (usually fat or a part of the small intestine) from the abdomen into the upper inner thigh in the groin region. It is also called a femorocele or crural hernia.

Related anatomy:

The femoral canal is a narrow space through which the femoral vein, artery and nerve leave the abdomen and enter the thigh. Sometimes the space is large allowing a part of the intestine to protrude into it leading to a femoral hernia.

Causes of femoral hernia

  • Obesity, chronic cough or constipation and lifting heavy weights are contributing factors.
  • Sometimes men tend to strain while passing urine because of an enlarged prostate which may cause a hernia.

Symptoms and signs of femoral hernia

A femoral hernia shows up as a small bulge in the upper inner thigh in the groin region. It may be mistaken for an inguinal hernia. The distinguishing factor is the location; an inguinal hernia occurs above the groin crease while a femoral hernia is below it. A hernia may get larger as time passes, other than that; it may not have any symptoms.

If you a hernia that has just changed colour or suddenly become painful or is associated with abdominal pain, nausea and vomiting, get medical care immediately as the hernia may be strangulated.

The bulge may or may not disappear in the lying down position. If it does not disappear on gentle pressure it is called an irreducible hernia and needs prompt medical attention.

Complications that may arise

  • Incarceration: When the hernia becomes stuck or fixed and cannot go back on gentle pressing it is said to be incarcerated.
  • Strangulation: When a part of the intestine herniates the blood supply to that part is cut off leading to death of the tissue and a discolouration of the overlying skin. This condition requires immediate surgery.

Detecting femoral hernia

The diagnosis is based on history and positive findings on examination by a physician. It should be distinguished from an inguinal hernia. USG or CT scan can reveal the contents of a femoral hernia and also confirm the diagnosis.

Treatment of femoral hernia

A femoral hernia if irreducible requires regular monitoring until surgery is scheduled and surgery to prevent complications which could be fatal. The principle of surgery is to put a plastic mesh to prevent a recurrence and strengthen the abdominal muscles. Also if the hernia remains incarcerated for a long period of time the tissue for example, small intestine may die leading to further complications. In 5-10% of cases the femoral hernia recurs even after surgery.

Prevention of femoral hernia

  • Lose weight till you attain the optimum weight for your height.
  • While lifting heavy weights keep the back straight and bend the knees.
  • If you have to strain while passing urine, it could be sign of an enlarged prostate in men. It will be worthwhile to undergo a check-up.
  • Avoid constipation by choosing to follow a high fibre diet and increase your consumption of drinking water.
  • Avoid chronic cough by giving up smoking if that is the cause.

Written by Dr Nisreen Nakhoda, General Physician

Photograph via sxc.hu

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