femoral

Femoral hernia: description

In femoral hernia, a so-called fractured bag everts through a weak spot in the tissue. This can be felt and seen by the doctor, especially with increased pressure in the abdomen. A femoral fracture consists of a Bruchpforte, a break bag and the Bruchinhalt. The hernia is at the femoral hernia a maximum of one centimeter and is located below the inguinal ligament on the thigh. The fracture sac often contains bowel parts.

About five percent of all hernias are femoral hernias. It occurs three times more often in the woman than in the husband, and affects in particular women in old age. In about 40 percent of the femoral hernias the hernia sac is already trapped at the time of diagnosis. Nine percent of women and 50 percent of men simultaneously suffer from inguinal hernia.

Femoral hernia: symptoms

Femoral hernias usually cause no symptoms at the beginning. If pain occurs, it is often uncharacteristic and located in the inguinal region. Especially in case of physical stress, the pain in the thighs radiate, causing swelling in the groin. Sometimes the swelling is confused with a lymph node located there. When the hernia sac is trapped, the pain often radiates into the groin, stomach and inner thigh.

Femoral Hernia: Causes and Risk Factors

The cause of femoral hernia is a weak spot in the tissue of the abdominal wall. This consists of abdominal muscle and connective tissue structures such as so-called aponeuroses and fascia, which ensure optimal stability. There are, however „Gaps in the inguinal region that are not supported by either aponeurosis or muscle and thus constitute a natural weak spot.

This “breaking point” is located in the femoral hernia behind the inguinal ligament, where the vessels of the thigh run. Excessive pressure in the abdomen and weak connective tissue may cause femoral hernia.

Why the femoral hernia arises in some people is not yet clear. However, there are several causes that can favor femoral hernia:

These include in particular repeated pregnancies, obesity and an increasing collagen deficiency with age. In certain clinical pictures, such as Marfan syndrome or Ehlers-Danlos syndrome, there is a congenital collagen metabolism disorder.

In addition, a femoral hernia often arises after an inguinal hernia operation – for example, by the surgical technique used. Coughing, pressing or heavy lifting also increase the pressure in the abdomen so that tissue can escape.

Femoral hernia: examinations and diagnosis

If a femoral hernia occurs, you should consult a specialist in surgery and visceral surgery. The doctor first collects the medical history and then examines you exactly. Possible questions of the doctor can be:

• Since when do the complaints exist?
• Have you ever been operated on?
• Does the pain radiate?
• Do you have an accompanying disease that is associated with a collagen metabolism disorder?

The femoral hernia examines the doctor lying and standing. He asks you to squeeze vigorously. If he can feel the fracture sack below the inguinal ligament, the diagnosis can be made easily – in the case of overweight, the tactile findings are often difficult. With an ultrasound examination, the doctor can differentiate the femoral hernia of a inguinal hernia in larger fractures. Even swollen lymph nodes are excluded.

Femoral Hernia: Treatment

A femoral hernia is always operated because it can not regress on its own. Due to the small hernia, intestinal sections can easily become trapped. An operation is required.

Depending on whether a femoral hernia occurs alone or together with a inguinal hernia, various surgical techniques are used. In addition to the classic, open surgery, it is also possible to operate using a keyhole technique (minimally invasive). The surgeon only makes very small abdominal incisions, through which he introduces his instruments.

Thigh Hernia Surgery: Open Surgery

In open femoral fracture surgery, the fracture sack is opened either from the groin area or from the thigh area. The breakage bag is then removed, pushed back and closed.

Isolated femoral hernia

In an isolated femoral hernia, the surgeon operates without opening the inguinal canal. The skin incision is placed obliquely below the inguinal ligament. After the hernia has been pushed back, the hernia is sutured.

Closed operation

If a femoral hernia can be pushed back, the operation with the so-called keyhole technique is possible. In this gentle surgical procedure only very small skin incisions are made, over which the surgeon introduces the surgical instrument and an optical device to his orientation (laparoscope). To stabilize the femoral hernia, the doctor may use a plastic net.

Thigh fracture surgery: complications

As with any surgery, wound infection or bleeding can occur. In rare cases it can come to embolisms (vascular occlusion).

Femoral hernia: disease course and prognosis

In general, one can femoral be treated well. A recurrence of the hernia is not very common and is between one and ten percent.