Femoral hernia
A hernia through the femoral canal, more common in women. Because of its anatomy, it requires careful evaluation and usually surgical repair.
Symptoms
- Bulge or swelling below the groin, near the fold between abdomen and thigh
- Pain or discomfort in the upper thigh
- Heaviness, burning or tenderness
- Swelling or pain that worsens with walking, coughing or straining
- Sometimes only pain, with little visible swelling
Key characteristics
- More common in women, especially after the age of 50
- Located below the inguinal ligament, medial to the femoral vessels
- Often small and easily overlooked
- Higher risk of incarceration compared with many inguinal hernias
Risk of incarceration
The femoral canal is narrow. A femoral hernia that becomes hard, very painful, non-reducible or is associated with nausea or vomiting requires urgent surgical assessment because of the risk of strangulation.
Diagnosis
Clinical examination of the groin and upper thigh, together with dynamic ultrasound, is usually sufficient. Laparoscopy is useful to rule out associated inguinal or bilateral hernias.
Treatment
Because of the higher risk of complications, surgical repair is usually recommended once the diagnosis is made. The approach can be open or laparoscopic/robotic TAPP, depending on the patient's anatomy, previous surgery and associated hernias.
