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Femoral Hernia : Definition, Symptoms, Complication, Diagnosis, and Treatment

Saturday, September 1st 2012. | Digestive System, Surgical

Femoral Hernia Definition

The word “hernia” means the output of an organ of its usual place, through a hole (or holes) natural.

As part of the femoral hernia, a part of the “gut” comes through a natural orifice below the line Malgaigne (this is an imaginary line on the skin corresponding to the projection of a ligament called the inguinal ligament, and connects the anterior superior iliac spine of the ilium of the pelvis to the spine of the pubis). 

We speak simply of femoral hernia when the hernia is located in the groin, otherwise we speak of inguinal herniaThe contents of the sac can be formed omentum (sheet surrounding the intestine), small intestine (small intestine, the most common), large intestine (colon), ovary (female).

Hernia is a benign, common to all ages, finding themselves more frequently in infants and young children (since it is a natural orifice, congenital) or elderly patients (by muscle weakness). The risk of femoral hernia is more important for women, while inguinal hernia is more common in men. It can be on one side (unilateral) or present on both sides (bilateral).

The risk factors for the occurrence of hernia is anything that increases the pressure in the abdomen, that is to say, chronic cough, wearing heavy loads, benign prostatic hyperplasia (an enlarged prostate which requires ” push “to urinate), constipation, pregnancy.

Femoral Hernia

Femoral Hernia (img thanks to wehealny.org)

Femoral Hernia Symptoms

The hernia appears as a “ball” which is more or less visible depending on your position (it can be quite invisible at times, usually when lying down, then out, usually during abdominal efforts such as heavy lifting or prolonged standing).

Its size is very variable, an apricot grapefruit or more. Its size is not correlated with a degree of urgency of intervention, nor to any serious and can be very impressive.

It is mostly painless and totally reducible (that is to say that gently pressing it comes to the “return to the womb”). It represents the most aesthetic or physical discomfort, and can sometimes be sensitive because of power.

The diagnostic difficulty is present in an incipient hernia, it is very small. Can experience occasional discomfort in the groin, which can be attributed to ligament pain most often.

Femoral Hernia Complication

The risk of complications from the hernia is when it becomes painful and brutal that it can not be reduced (go alone) or with assistance: this is called a strangulated hernia (often look red and tense the “ball”), and it is a surgical emergency because the contents of the hernia (a piece of small intestine in most cases) is then stuck (you can imaging it as a small purse that is shut with a cord). Intestinal transit can no longer be normal: it is bowel obstruction (manifested by a judgment of materials and gas, abdominal pain, sometimes associated with vomiting). This is a surgical emergency, the prognosis is engaged, the “piece of intestine” can become necrotic. In the latter case, it will be removed.

The femoral hernia is the purveyor of constriction (among other hernias, inguinal and umbilical).

Femoral Hernia Additional Tests

It is a clinical diagnosis, that is to say that it is your doctor or surgeon who will feel your hernia. There is no need for further consideration, except in the case of a complication, or it will most often be required to perform emergency abdominal CT scan, or ultrasound to a lesser extent, in order to know the contents of the hernia.

Femoral Hernia Tratment

Curative treatment is surgical. It will be discussed in case of high risk surgery (especially in the elderly).

Restraint belts have not demonstrated efficacy, especially among young adults.

Surgical treatment is usually performed laparoscopically nowadays (that is to say, by the introduction of a camera and tools, with completion of the transaction by the “inside”), which allows a reduction in postoperative (scarring, infections …) and may also occur, depending on the location and size of the hernia through percutaneous (that is to say, it makes an opening directly next to the hernia, the skin). The type of approach (or choice of surgery) will be determined by your surgeon.

Surgery is, in most cases, to reduce the hernia sac (reinstating the abdomen), and close the “hole” (or aperture) either naturally with the surrounding muscles and nonabsorbable suture, or the using a prosthesis (which can be thought of as a net very tight, tense).

This surgery, very common, can be performed on an outpatient basis (that is to say, you go in the morning and get out in the afternoon). It takes about 30 minutes. Operating risks are normal anesthesia, and possible complications (infectious, allergic …) but rare. It is a well-known and frequent intervention.

After surgery, your surgeon will advise against the heavy lifting and recovery of physical activity too quickly before a proper healing.

In an attempt to prevent the occurrence or recurrence of hernia, you must:

  • Reduce pressure to the abdomen, that is to say, the fight against constipation (healthy diet, laxatives treatment if needed), chronic cough, limit the heavy lifting (and then wear them bending knees and keeping your back straight).

What specialty is concerned?

It is the visceral surgeon who will operate your hernia. More broadly, it takes care of the entire abdomen (intestines, liver, stomach …) Your doctor will refer you to one of them.

 

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