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Femoral hernia

Definition

A femoral hernia is a bluge in the upper part of the thigh near the groin.

A hernia occurs when the contents of the abdomen (usually part of the small intestine) push through a weak point or tear the thin muscular wall of the abdomen, which holds the abdominal organs in place.

Alternative Names

Femorocele; Enteromerocele; Crural hernia

Causes, incidence, and risk factors

Most of the time, there is no clear cause of a hernia. Some hernias may be present at birth (congenital), but are not noticed until later in life.

Some factors that contribute to the development of a hernia include:

• Chronic constipation
• Chronic cough
• Heavy lifting
• Obesity
• Straining to urinate because of an enlarged prostate

Femoral hernias tend to occur more often in women than in men.

Symptoms

You may see a bulge in the upper thigh next to the groin.

Most femoral hernias cause no symptoms. There may be some groin discomfort that is worse when you stand, lift heavy objects, or strain.

Sometimes, the first symptoms are abdominal pain, nausea, and vomiting. This may mean that the intestine is blocked, which is an emergency.

Signs and tests

The best way to tell if there is a hernia is to have your health care provider perform a physical exam.

If there is any doubt about the exam findings, an ultrasound or CT scan may be helpful.

Treatment

Hernias generally get larger with time, and they usually do not go away on their own. Surgery may be done to repair a femoral hernia.

Surgery will relieve discomfort. Also, if the hernia is not treated, there is a risk of tissue getting stuck or trapped in the weak area (called incarceration). This tissue may die off if it remains incarerated for too long.

Often, a piece of plastic mesh is surgically placed to repair the defect in the abdominal wall.

Support Groups

Expectations (prognosis)

The chances of a femoral hernia coming back after surgery are about 5 - 10%.

Complications

If the intestine or other tissue in the femoral hernia becomes stuck (incarcerated) or becomes gangrenous (strangulated), emergency surgery is needed.

Calling your health care provider

Call your health care provider or local emergency number (911) or go to the emergency room right away if:

• You have a painful hernia that cannot be pushed back into the abdomen using gentle pressure.
• You develop a painful hernia along with nausea, vomiting, or abdominal pain.
• Your hernia becomes red, purple, dark, or discolored.

Call your health care provider for an appointment or advice if you have a bulge in the upper thigh next to the groin.

Prevention

There may not be any way to prevent a hernia from developing, or, if you already have a hernia, to stop it from becoming stuck or gangrenous. However, trying to avoid putting too much pressure on the abdominal wall may help.

• Avoid constipation by increasing your fiber intake and drinking enough fluid.
• Lose weight if you are overweight.
• See your health care provider if you have difficulty with urination, such as frequent urination, straining with urination, or waking up at night to urinate. These may be symptoms of an enlarged prostate.
• Use proper lifting techniques.

References

Malangoni MA, Rosen MJ, eds. Hernias. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 44.