Femoral hernia

Alternative names
Femorocele; Enteromerocele; Crural hernia

Definition
A femoral hernia is a protrusion of a loop of the intestine through a weakening in the abdominal wall, located in the groin near the thigh.

Causes, incidence, and risk factors

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

In a femoral hernia, a bulge is usually present in the upper part of the thigh, just below the groin. Femoral hernias tend to occur more often in women than in men.

A femoral hernia may become incarcerated (stuck) and strangulated (the loop of bowel loses its blood supply). Nausea, vomiting, and severe abdominal pain may occur with a strangulated hernia. This is a medical emergency!

Symptoms

     
  • Groin discomfort or groin pain aggravated by bending or lifting  
  • Tender lump in the groin or upper thigh

Signs and tests

A physical examination reveals the hernia. Tests are usually not necessary.

Treatment

Hernias generally get larger with time, and they usually do not resolve on their own. If the patient’s health permits surgery, elective surgical repair will be performed to relieve discomfort and to prevent complications such as incarceration and strangulation.

A hernia that cannot be pushed back into the abdominal wall by pressure may be trapped or strangulated. Without treatment, a strangulated section of the intestine will die, because the blood supply is inadequate. Urgent surgery is required for incarcerated or strangulated hernias.

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

Expectations (prognosis)

The outcome is usually quite good if the hernia is treated properly. The rate of hernia recurrence after surgical repair is generally less than 3%.

Complications

A strangulated intestine can result in gangrene, a life-threatening condition requiring emergency surgery.

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if a hernia cannot be pushed back into the abdomen by gentle pressure, or if nausea or vomiting develop.

Prevention

Overweight patients may be able to prevent hernias from forming by losing weight.

Chronic cough, constipation, and prostatic hypertrophy may lead to straining with urination or defecation, which is also thought to contribute to the formation of hernias and should be addressed prior to hernia repair.

Johns Hopkins patient information

Last revised: December 3, 2012
by Gevorg A. Poghosian, Ph.D.

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