With a femoral hernia (also called a femorocele or crural hernia), weak spots in the tissues below the inguinal ligament become penetrable. As a result, parts of the organs fall into a so-called hernial sac, which runs along the inner side of the thigh near the large veins. Generally, here, the so-called omentum majus, a mesh-like structure on the digestive organs, falls into the hernial sac. Parts of the intestine or ovaries can also be affected, however.
The risk with a hernia is always that the organs will become incarcerated and so might no longer be able to perform their function. Because the gap in a femoral hernia is so narrow and is located in an area of the body where movement is vigorous, this risk is particularly high. For the same reason, the pain of a femoral hernia is generally more severe than for an inguinal hernia, for example. Surgery is almost always necessary in order to prevent damage to the organs and to treat the symptoms.
The majority of those who suffer from an inguinal hernia are older women. Men are only infrequently affected. Severely overweight women are at particular risk. Previous pregnancies or a connective tissue weakness also increase the risk, however. Where men are affected, previous surgery for an inguinal hernia is generally the cause. For this reason, good follow-up care is necessary following this type of surgery.
A typical symptom of a femoral hernia is a palpable bulge or swelling in the thigh. However, this bulge is often difficult to detect or may even not appear at all in patients who are severely overweight. This makes the diagnosis more difficult.
Some patients have no discomfort at all over a long period; others complain of diffuse pain in the groin or irregular defecation. Usually, severe pain appears if the prolapsed organs become incarcerated. This radiates from the groin into the thigh and becomes worse on straining. With this type of symptom, immediate surgery is generally required in order to prevent damage to the organs.
Along with asking questions and palpation, the physician also employs ultrasound examination for his diagnosis. This generally provides a clear image and helps to distinguish the condition from other problems. One possible differential diagnosis (that is, another medical condition involving a very similar diagnosis and which therefore could be confused with this) is a swollen lymph node.
If a femoral hernia has appeared, the physician will generally recommend surgery within the framework of so-called hernia surgery. If severe symptoms are already present, the surgery is urgent and is generally required as an emergency. But even if symptoms have not yet appeared, the gap in the tissue should be closed as quickly as possible in order to prevent incarceration of the prolapsed parts of the organs.
Various surgical techniques can be performed. What techniques are considered in the individual case depends on the medical practitioner, the exact findings and the patient’s condition. Some surgical techniques are invasive (“open”, that is, an incision must be made), while others are minimal invasive (here, the surgery is performed via tiny incisions, using the “keyhole technique”).
In all cases, the surgeons carefully slide the contents of the hernial sac back into position and then close the hernial orifice during the operation. A synthetic mesh can also be inserted in order to reinforce the area. In this way, the risk of the recurrence of the femoral hernia later on is reduced.
Serious complications rarely occur in the procedure. As with any surgery, wound infection or bleeding is possible. In rare cases, emboli (vascular obstruction) may also appear, which can become dangerous if they are not treated. For that reason, you should always advise your attending physician immediately if symptoms suddenly appear following surgery. With careful surgery and thorough follow-up care, the femoral hernia generally disappears permanently. A femoral hernia reappears at a later date in only approximately one to ten percent of cases.
If you have diffuse pain in the groin, you should consult a physician as soon as possible in order to exclude a femoral hernia. The problem is generally quickly taken care of using up-to-date surgical techniques.
