Femoral Hernia

Aka: Femoral Hernia

1. See Also
   1. Inguinal Hernia
2. Epidemiology
   1. Accounts for 4% of Groin Hernias (96% are inguinal)
   2. More common in elderly women
   3. Gender predisposition: Female by 3 to 1 ratio
      1. Femoral seen less than Inguinal Hernia even in women
3. Pathophysiology
   1. Associated with increased intra-abdominal pressure
   2. Hernia sac bulges into femoral canal
      1. Femoral canal is continuation of femoral sheath
      2. Femoral canal lies immediately medial to femoral vein
4. Symptoms and Signs
   1. Groin Pain and tenderness often absent
      1. Even strangulation occurs often without pain
   2. Hernia sac neck location palpable
      1. Lateral and inferior to pubic tubercle
   3. Large Femoral Hernias may bulge over inguinal ligament
      1. May be difficult to distinguish from Inguinal Hernia
5. Differential Diagnosis
   1. Inguinal Hernia
   2. Inguinal Lymphadenopathy
   3. Varix of Saphenous Vein
      1. Thrill on palpation
      2. Fills on standing and empties while supine
   4. Infectious Bubo
      1. Chancroid
      2. Syphilis
      3. Lymphogranuloma venereum
6. Complications
   1. Strangulated Hernia (common)
      1. Patients unaware of hernia before strangulation (50%)
7. References
   1. Goroll (2000) Primary Care Medicine, p. 431-4
   2. Degowin (1987) Diagnostic Examination, p. 489-96
   3. Bax (2001) Am Fam Physician 59(4):143-56