Femoral Hernia: Get the Facts

Our human bodies are a complex network of nerves, blood vessels, muscles, and visceral organs. While our skin is the outermost layer holding everything together, on the inside, it is a network of strong muscle fibers that hold all our internal organs in place. A hernia occurs when there is a weak spot in this network of muscle and some of the internal organs or fatty tissues that start to push through this spot. In some cases, this is not life-threatening, but in more serious cases that are left untreated, hernias can be very painful and may lead to severe organ damage and death.

A femoral hernia is also known as a femorocele. It occurs when your inner abdominal tissues protrude through the weaker wall of the femoral canal. This type of hernia appears as a lump near the thigh or groin. The femoral canal contains smaller veins, artery, and nerves. It is more prominent when you stand upright and is pushed back when you lie down. Femoral hernias are less common than inguinal hernias, which also occur in the groin.

Who is at risk?

A femoral hernia usually occurs in women. Immediate medical attention is required when the intestines become strangulated, which leads to the blockage of blood supply. Prolonged blockage of blood supply will lead to severe tissue damage and therefore must receive immediate medical attention. 

Causes of Femoral Hernia

While the exact cause of femoral hernia is still unknown, a person who has a weak femoral canal by birth can be at risk of this condition. The femoral canal can also weaken over time. When pressure is put on the weakened muscles, it causes hernia. Some of the factors that may overstrain the muscles include:

• Frequent constipation
• Pregnancy
• Lifting heavy loads
• Obesity or being overweight
• Difficulty while urinating

Symptoms

Since small and medium-sized femoral hernias are asymptomatic, you may not be able to realize that you have one. However, large hernias are visible and usually associated with pain and discomfort. Because a femoral hernia is located very close to the hip bone, it may cause immense pain in your hips in severe cases. When intestine strangulation occurs, it may put a patient's life at risk. In such severe cases, the patient may experience symptoms such as vomiting, nausea, or pain in the groin and stomach.

Diagnosis 

The doctor may perform a physical examination to diagnose a femoral hernia. Moreover, an ultrasound of the groin and abdomen may also be done to confirm the condition.

Treatment 

Small to moderate-sized femoral hernias do not necessarily need any specific treatment unless immense pain and discomfort are experienced by the person. In such cases, the doctor may suggest surgery, which is performed under general anesthesia. Surgery is especially needed when strangulation of the intestine occurs. In some cases, a section of the bowel also becomes stuck in the femoral canal. Surgery is also required in this case. Femoral surgery can be performed in two ways: open and laparoscopic. An open surgery involves a single large cut at the affected area and has a long recovery period. On the other hand, a laparoscopic surgery involves several smaller incisions and has a shorter recovery period.

Before the surgery, the patient will be given special instructions about a required fasting period. Both types of surgeries will involve pushing a lump of fatty tissue or intestine back into place and then repair the weakened part of the muscle with the help of a mesh plug. Finally, the surgeon will close the incision or incisions using sutures or surgical glue. 

Risks Associated with Femoral Surgery

Just like any other operation, some risks are associated with femoral surgery, too. Although most of the time, the operation is successful, one may experience complications in rare cases, which include:

• A lump below the incised area
• Difficulty urinating
• Injured femoral vein
• Injured bowel
• Temporary leg weakness
• Pain or numbness in the groin area

Conclusion

Femoral hernias occur when a bit of fatty tissue or intestine pushes through a weakened spot in the muscle network into the femoral canal at the groin and forms a lump. Femoral hernias are more common in women because of the wider pelvis.

In some cases, femoral hernias are small and have no symptoms. In other cases, the lump might be larger and even painful. If a part of the intestine becomes trapped in a hernia, the patient could experience severe stomach pain, nausea, and vomiting. It is a dangerous condition that could lead to a loss of blood supply to the trapped part of the intestine and ultimately cause tissue damage. This condition needs immediate surgery to release the trapped part of the intestine.

Surgery might be open surgery with one incision of about three to four centimeters or a laparoscopic surgery with three smaller incisions. Both types of surgery could last for half an hour to 45 minutes. In the event that part of the intestine has suffered damage due to the loss of blood supply, then that portion would need to be removed and the two healthy ends joined together. In this case, surgery might take more time to complete.

Post-surgery, the patient needs to follow the care guidelines provided by the hospital. Medical help should be sought if the patient experiences any of the following symptoms after the operation:

• Fever
• Abdominal pain
• Abdominal swelling
• Bleeding at the site of the incision
• Redness around the incision
• Nausea and vomiting
• Difficulty passing urine

The Outlook

While a femoral hernia is not life-threatening, certain complications as mentioned above can be fatal. Therefore, it is advised to seek medical attention immediately if you experience any of the above-mentioned symptoms. Adopting positive lifestyle changes can also bring a lot of improvement in your condition.

Maintaining a healthy diet and lifestyle, which leads to good digestion and bowel movements as well as avoiding excessive strain on the lower abdomen could not only help in preventing a femoral hernia but will also help prevent the recurrence of one after surgery.