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At least 19 recordsLinked to original sources
PubMed2003

Femoral hernia repair.

Femoral hernia repair has a long history. In the nineteenth century, simple closure of the femoral orifice by the femoral approach was favored. Such renowned surgeons as Bassini, Marcy, and Cushing authored papers about the femoral approach to femoral hernia. The recurrence rate was so high, however, that it was replaced by the inguinal approach. The man who popularized the inguinal approach was Chester McVay, who demonstrated the precise insertion of the tranversus abdominis muscle and transversalis fascia to the Cooper's ligament. He used Cooper's ligament for the femoral hernia repair by the inguinal approach. The complication and recurrence rate after the Cooper's ligament repair for femoral hernia was not satisfactory, however, due to tension on the approximated tissues, which caused postoperative pain and inability to resume normal activities. Irving Lichtenstein first introduced the plug technique to femoral hernia repair and it was further developed by Gilbert and Rutkow. In the present series, all elective cases were repaired by the PerFix mesh plug technique without any complications. Patients were discharged from the hospital on the first postoperative day and returned to normal activities shortly thereafter. These patients had few complaints of pain in the groin. The operating time using a PerFix plug was markedly shorter when contrasted with the Cooper's ligament repair. No infection of the prosthesis occurred, even in the cases in which the small intestine was necrotic and resected. From our 7-year experience of mesh plug femoral hernia repairs, I have come to regard this operation as the first choice in elective and noninfected cases of femoral hernia. In strangulated cases in which severe infection occurs. Cooper's ligament repair should be used, because there is a risk or infection to implanted prosthesis. Finally, femoral hernia is usually thought of as requiring emergency surgical treatment. Only 30% of our cases were treated as emergency operations, however, whereas 70% were elective. Unless patients complain of severe abdominal pain or ileus, surgeons need not perform emergency operations. In summary, the PerFix mesh plug hernia repair for femoral hernia has resulted in a reduced recurrence rate, shortened hospital stay, and a low rate of postoperative complications.

Digestive System Surgical Procedures↗
PubMed1997

[Femoral hernia].

A femoral hernia descends through the femoral canal beneath the inguinal ligament. Rare in man, it occurs in women over 50. It can be difficult to recognize and any symptoms of the groin may rise the diagnosis. Strangulation is a frequent (often first) manifestation of femoral hernia. Early diagnosis is important to avoid intestinal resection, a source of morbidity and mortality. Surgical treatment is mandatory for all diagnosed femoral hernia.

Aged↗
PubMed1981

The value of ultrasound in the diagnosis of nonpalpable femoral hernias.

Nonpalpable femoral hernias were diagnosed in four patients by the ultrasonic visualization of a space-occupying mass medial to the femoral vein. All four patients had surgical verification of their ultrasonic diagnoses. Therefore, we suggest the liberal use of nonpalpable and clinically questionable femoral hernias. In patients with incarcerated femoral hernias, early sonographic diagnosis prior to strangulation may decrease the high mortality associated with this complication.

Adult↗
PubMed2004

Appendicitis in incarcerated femoral hernia.

BACKGROUND: Femoral hernia can rarely present with the content of appendicitis. We report on an elderly female who was admitted to our emergency department with a painful groin mass. METHODS: An 85-year-old woman presented with a 7-day history of right groin pain and swelling. She also had complaints of nausea, vomiting, and right lower quadrant abdominal pain. Physical examination revealed a right groin mass in the femoral region, which was painful on examination. Abdominal examination ended with normal findings except bilateral lower quadrant tenderness. Ultrasonographic examination revealed a hernia sac containing suspected aperistaltic bowel segment with edematous wall. RESULTS: The patient underwent surgery. During exploration of the right groin region, a strangulated femoral hernia sac containing appendicitis was detected. CONCLUSION: Surgeons should be aware of the existence of this kind of atypical presentation of appendicitis.

Abdominal Pain↗
PubMed1990

Thrombosed sapheno-varix: an important and unusual differential diagnosis of strangulated femoral hernia.

An incarcerated femoral hernia often requires prompt operative management to decrease the risk of bowel strangulation, perforation and death from peritonitis. We present a case of a 60-year-old man who had a clinically irreducible right femoral hernia, and in whom a Richter's hernia could not be excluded. He was found to have a thrombosed sapheno-varix with no evidence of a femoral hernia. Thrombosed sapheno-varix presenting as a strangulated femoral hernia has never previously been described in the literature.

Diagnosis, Differential↗
PubMed1993

[Femoral hernia in children].

Femoral hernia is rare in adults and even less common in children, to the point that expert surgeons have limited experience with it. Eleven patients with femoral hernia have been operated upon in our service during the past 15 years. Preoperative diagnosis was made in 6 cases (54.5%), and we underline that the ideal therapy began with this early diagnosis. We review the etiologies, clinical findings and treatment of femoral hernia in children.

Age Factors↗
PubMedDate not supplied

The "Fletching": a new implant for the treatment of inguino-femoral hernias.

Inguino-femoral hernias present a special problem. Destruction of vital structures such as the inguinal ligament, the femoral sheath, the transversalis fascia and the conjoined tendon, is usually extensive. Repairs have often relied upon the use of sheets of prosthetic materials but never on a three dimensional implant. This article will examine such an implant, the "Fletching". The latter is a three leaved prosthesis with a common reinforced backing, the aim of which is to replace the inguinal ligament and associated structures necessary for the successful repair of the much feared inguino-femoral hernia. This prosthesis has been implanted in 24 patients with excellent results. Follow-up has now been longer than 2-1/2 years and careful steps are taken to continue this follow-up.

Adult↗
PubMed1999

Femoral hernia in children.

BACKGROUND/PURPOSE: Femoral herniae are uncommon in children and easily misdiagnosed. To evaluate performance with femoral hernia in children, the authors reviewed their experience for the past two decades. METHODS: All patients under 15 years of age with femoral hernia (January 1977 to January 1998) were reviewed. Age, gender, presentation, surgical findings and procedure, and previous repair were recorded. RESULTS: There were nine girls (53%) and eight boys (47%). Age range was 2 to 15 years. Thirteen were right side (77%), three were left side (18%), and one was bilateral (6%). All presented with a recurrent lump in the groin, one with incarceration. Duration of symptoms ranged from 1 day to 3 years (median, 3 months). Six cases were diagnosed correctly preoperatively (35%); the others were thought to be either an inguinal hernia or recurrent inguinal hernia. CONCLUSIONS: Femoral hernia in childhood is a challenging clinical problem because of its rarity and similar clinical presentation as indirect inguinal hernia. The frequency with which an incidental indirect inguinal hernia sac or patent processus vaginalis can be found at surgery can perpetuate a misdiagnosis. The absence of an expected indirect inguinal hernia sac or an apparent recurrence of an indirect inguinal hernia should lead to consideration of a possible femoral hernia.

Adolescent↗
PubMed1990

Femoral hernia in children.

Femoral hernia is rare in children. Unfamiliarity with the occurrence of this condition may lead to incorrect diagnosis and delayed treatment. This mistake can be obviated by careful clinical examination.

Child↗
PubMed2003

Childhood femoral hernia: a commonly misdiagnosed condition.

Femoral hernia is a rare surgical entity in the paediatric age group. The diagnosis is still a challenging issue. The aim of our study was to review our experience with femoral hernias in children during the past 21 years. We reviewed retrospectively the medical records of all patients who underwent femoral hernia repair in our institution between 1980 and 2000. Thirty-eight children (20 females, 18 males) with the median age of 5.5 years underwent 42 femoral hernia repairs over a 21-year period. Correct preoperative diagnosis was obtained in 20 (53%) cases. Of the 18 (47%) misdiagnosed cases, 11 were found to have a femoral hernia at negative exploration for a clinically diagnosis of inguinal hernia and 7 were found to have a femoral hernia 1 week to 18 months (mean 2.5 months) post repair of a presumed inguinal hernia. Median follow-up time was 12 years (range, 6 months-22 years). Recurrent femoral hernias occurred in five (13%) patients 6 months to 3 years (mean 13.5 months) after initial hernia repair. This study shows that femoral hernia is still a commonly misdiagnosed condition. A correct preoperative diagnosis will lead to appropriate surgical management, thus avoiding unnecessary morbidity and preventing unnecessary reoperations.

Child↗
PubMed1991

Femoral hernia in children: an infrequent problem revisited.

Femoral hernias are of very rare occurrence at any age, but are exceedingly rare in the pediatric population. A 10-year survey, 1979-1989, of our experience with pediatric hernias produced a total of 1,134 inguinal hernias and 6 femoral hernias, supporting an incidence of 0.5% for femoral hernias in our population. The correct diagnosis was made in only two cases preoperatively. These two patients had undergone inguinal herniorrhaphies less than 6 months prior to presenting with recurrent groin masses. Femoral hernias were most frequently misdiagnosed as inguinal hernias. Inclusion of this entity in the differential diagnosis of groin masses, an accurate preoperative physical exam, and a careful surgical exploration will allow one to make the correct diagnosis and prevent unnecessary reoperations. In addition, early recurrence of a groin mass after inguinal exploration and herniorrhaphy should make one suspicious of a femoral hernia. At surgery, our recommendations include a simple infra-inguinal exploration medial to the femoral vessels when an inguinal hernia is unexpectedly not found at groin exploration and a Cooper's ligament repair when a femoral hernia is encountered. All six cases in our review were repaired with Cooper's ligament repair without complication.

Child↗
PubMed1997

Reappraisal of femoral hernia in children.

BACKGROUND: Femoral hernias are rare in children, accounting for fewer than 1 per cent of all paediatric groin hernias. Misdiagnosis is common and a source of complications. There is no consensus on the age and sex distribution or the optimum method of repair. METHODS: A personal experience of four children with femoral hernia is reported together with an institutional review of a further ten hernias encountered during the past 11 years. RESULTS: Peak incidence was between 5 and 10 years of age. Misdiagnosis was common, partly because of the variability in presenting symptoms and signs. In this series, boys were more commonly affected but a literature review indicated a similar sex incidence. CONCLUSION: A femoral hernia should be positively excluded if the operative findings at inguinal exploration are inconsistent with the preoperative signs and in any child with a suspected recurrent inguinal hernia. Excision of the sac and repair of the femoral canal is curative.

Adolescent↗