Hernias are protrusions of part of an organ or fatty tissue through weakened areas of the abdominal wall. An inguinal hernia, specifically, is a type of hernia that develops in the inguinal area, and more specifically in the femoral ring, below the inguinal canal and inguinal ligament. This particular form of hernia occurs when a portion of the intra-abdominal organs protrudes through a weak point in the femoral ring. A femoral hernia can become apparent bilaterally, either on the right or left side of the body, therefore it is referred to as a right or left femoral hernia respectively. Femoral hernias are more common in women, accounting for about 10-15% of all cases of this form of hernia, with a female to male ratio of 3 to 1. Although less common than inguinal hernias, femoral hernias can lead to serious complications if left untreated.
Femoral hernias: Causes
The underlying cause of developing a femoral hernia is usually multifactorial. One of the most basic is the existence of a weak point in the abdominal wall. A natural weakness or defect in the femoral ring can be present from birth, making some people more prone to developing femoral hernias over time. This congenital weakness can be aggravated by increased intra-abdominal pressure due to factors such as obesity, chronic cough, prolonged constipation or lifting heavy objects. At the same time, additional factors can increase the risk of femoral hernia. These include advanced age, female gender, pregnancy, and medical history of previous abdominal surgery.
Femoral hernia symptoms
The clinical representation of a femoral hernia can vary, but the most common symptoms include a palpable lump in the groin and pain or discomfort. One of the most recognizable signs of a femoral hernia is the appearance of a soft, palpable lump in the groin or upper thigh area. This bulge may become more prominent during activities that increase intra-abdominal pressure, such as coughing or stretching. Patients with a femoral hernia also often experience pain or discomfort in the groin, which can be worsened by physical activity. The pain can range from mild to severe and may be accompanied by a feeling of heaviness or pulling.
Complications that femoral hernias can cause
The most common complication in almost all hernia cases is strangulation. Strangulation refers to the entrapment of the contents of the hernia, i.e. the intra-abdominal organ or tissue, in the narrow opening of the hernia. In this case, there is severe pain in the area where the hernia is located, redness and swelling, followed by symptoms related to intestinal obstruction, such as abdominal distension, nausea and vomiting. This condition, if not treated surgically in time, can cut off the blood supply to the contents of the hernia and consequently cause ischemia and necrosis of the trapped intra-abdominal organ.
Femoral hernia: Treatment
The treatment approach in case of femoral hernia or any other form of hernia is mostly surgical. This is because there is no chance that the contents of the hernia will return to its original position on its own. Therefore, surgery is the definitive treatment for femoral hernias and is recommended for most patients, especially those who are symptomatic or at risk of complications. The surgery involves returning the contents of the hernia to the abdominal cavity and strengthening the weakened abdominal wall with a special synthetic mesh. This operation, like most hernia procedures, is now performed laparoscopically in the majority of cases. This is because the minimally invasive nature of the laparoscopic technique offers significant post-operative advantages to patients, such as a reduction in post-operative pain and recovery time, but also an excellent aesthetic result, as the incisions are very small in size.
Femoral hernia is a less common but significant type of abdominal hernia that mainly affects women. Understanding the causes, symptoms, complications, and available treatment options is vital for early diagnosis and appropriate management. Surgery is generally the preferred approach to prevent potential complications and improve patients’ quality of life. The General Surgeons in Athens, who make up the Colon Rectal team, surgically treat many cases of femoral hernia, with the aim of improving the symptoms of each patient.
