Femoral hernia

What Is a Hernia?


Hernia, Femoral Hernia


“A hernia occurs when an organ squeezes through an opening in the muscle or tissue that holds it in place. In some cases, the intestines may protrude through a weakened area in the abdominal wall.”

– Dr Ganesh


Hernias occur mostly in the abdomen region, but they can also appear in the upper thigh, belly button, and groin areas. While most hernia conditions are not immediately life-threatening, they typically need surgery to prevent potentially dangerous complications.


Is a Hernia Considered an Emergency?


In some instances, whether it’s in adults or children, hernias can cause life-threatening complications. It is recommended that you seek emergency care if you experience symptoms such as nausea or vomiting, fever, or sudden pain.


Early medical care and changes can minimise symptoms. 

However, surgery is the only way to treat a hernia effectively. There are different types of surgeries available for hernia repairs, and your surgeon can advise on which is recommended for your condition.


While the prognosis for hernia repair surgery is typically good, it can depend on the nature of your hernia, the symptoms and overall health. For some, the hernia may recur following repair.


What Happens When You Experience a Hernia?


The most common symptom of a hernia is a bulge or lump in the affected area. For example, in the case of an umbilical hernia, it occurs as a bulge through this weak spot near the belly button or navel. 


One in five babies is born with an umbilical hernia. However, if the hernia does not resolve when the baby reaches four years of age, treatment may be required. You might also experience some pain and discomfort in the area around the lump.


In some types of hernia, such as hiatal hernias, specific symptoms may be observed, such as heartburn, trouble swallowing, and chest pain.

In many cases, hernias have no symptoms, and you may not know you have a hernia unless it shows up during a routine check-up or a medical examination for an unrelated problem.


Dr Ganesh: “It’s important to recognise the signs of a hernia and to see your doctor if you suspect that you have one. An untreated hernia won’t go away by itself. Your doctor can assess your hernia and recommend a suitable treatment for your condition.”


A femoral hernia is another form of hernia that may be less commonly experienced. This condition occurs mostly in women, though it can occur in men too. Unlike inguinal hernias which appear above the crease of the groin, this type of hernia is a painful lump which appears below the crease of your groin.


A case of femoral hernia was reported in 2014, documenting a 57-year-old male who was admitted with complaints of generalised abdominal pain, vomiting and constipation for seven days. Further investigation led to the discovery of his condition: Incarcerated Femoral Hernia. 


What Is a Femoral Hernia?


Femoral Hernia, Hernia

Femoral hernias, also known as a femorocele, occur when a weakness in your lower groin allows an intestinal sac to drop into the space near the femoral vein which transports blood from your leg. This space is known as your femoral canal. 


More so than an inguinal hernia, surgery is necessary to treat most cases of femoral hernia due to the high risk of complications such as obstruction and strangulation.


Women are more likely to suffer from a femoral hernia. While most femoral hernias do not cause symptoms, they may occasionally lead to severe issues if the hernia obstructs and compromises blood flow to the intestines. This is called a strangulated hernia and posts a health risk and requires immediate surgery.


What Causes a Femoral Hernia?


A femoral hernia is typically caused by a weak spot in your groin region and by excess pressure or strain placed on this weak spot. Women are far more susceptible to this condition than men. This is due to the broader shape of a woman’s pelvis and femoral canal.


Some factors which may increase pressure on this weakened area include:

  • Pregnancy and childbirth
  • Heavy exercise
  • Straining during chronic constipation
  • Having a frequent and persistent cough
  • Being overweight or obese


What Should I Consume if I Have a Femoral Hernia?


While there are no immediate dietary requirements where it comes to managing a femoral hernia, some habits may assist you in preventing your hernia from getting more significant. 


They are:

  • Drinking more water. Water and other fluids may prevent constipation and strain during a bowel movement. As a recommendation, drinking a minimum of 8 glasses of water daily would help to soften stools and improve bowel movement.
  • Eating high-fibre foods such as fruits, vegetables, legumes, and whole grains may prevent constipation and strain during a bowel movement, thereby aiding you in preventing your hernia from getting bigger.


How Is a Femoral Hernia Diagnosed?


The doctor will carry out a physical examination of your groin area to diagnose a femoral hernia. If your diagnosis is not immediately apparent, you might be asked to undergo a diagnostic imaging test such as abdominal ultrasound, CT scan or MRI by the doctor.


Do Femoral Hernia Go Away on Their Own?


A femoral hernia will not resolve on its own and will require surgery. The hernia may start as a small lump in the groin but can grow much more extensive overtime. 


A femoral hernia may also appear to grow and shrink as you perform various activities. For example, increased abdominal pressure during activities such as straining to have a bowel movement or sneezing may push more of the intestines into the herniated area, making the hernia appear to grow temporarily.


In the experience shared by Surgical Case Reports, an official journal of the Japan Surgical Society, the report details a 30-year-old lady presented with a painful 3cm x 2cm swelling. Though the swelling has been present for two years, the pain started only after a trivial blunt trauma over the swelling seven days ago. 


Further investigations discovered a rare form of infected femorocele. When not infected, it presents a painless inguinal soft cystic swelling, commonly in women of fourth to the sixth decade. Excision of the sac followed by hernia repair assisted her in her recovery.


What Are Some Possible Complications of a Femoral Hernia?


Possible complications include obstruction, whereby the tissues around your hernia or intestines become blocked by the hernia. This tissue may die if not immediately treated with surgery. One further complication is if your intestine happens to get incarcerated (‘stuck’) or strangulated (blood supply is cut off), this results in the death of tissue and formation of gangrene. 


If treatment is not carried out promptly, peritonitis, which is infection and inflammation of the abdomen lining and its contents, may occur. Peritonitis is a life-threatening condition which should be avoided.

Femoral hernia is typically caused by a weak spot in your groin region and by excess pressure or strain placed on this weak spot. Women are far more susceptible to this condition than men. This is due to the wider shape of a woman’s pelvis and femoral canal.


How Is a Femoral Hernia Treated?


To remove a femoral hernia entirely and prevent serious complications which may otherwise occur, surgery is necessary. A femoral hernia typically does not reduce in size or go away by itself. More often than not, it continues to grow larger. Planned surgery is preferred to an emergency as it would involve fewer complications.


If a femoral hernia is diagnosed promptly and suitably treated with surgery, the chances of it recurring is only between five to ten per cent. Should the femoral hernia get to a stage which requires emergency surgery, surgical complications can be more severe than that of the planned surgery.


When treating a femoral hernia, there are two methods of repair surgery. They are open hernia repair or laparoscopic hernia repair.


Open Hernia Repair


In a traditional open hernia repair, the surgeon makes an incision near your groin to access the hernia over the bulge site.


Laparoscopic Hernia Repair


Laparoscopic hernia repair is less invasive than an open hernia repair. The surgeon makes various small incisions surrounding the hernia bulge site. A tube with a camera on one end, known as a laparoscope, is inserted into one of the incisions, allowing the surgeon to get a better view of your abdominal cavity.


Both types of surgery have the same goal. The surgeon would place the bulging intestine or other intra-abdominal tissue and lining back through the hole in the abdominal wall. The hole is then sewed closed. A synthetic mesh material may be inserted into the abdomen to strengthen the area.


What Happens After I Treat My Hernia?


After your surgery, it is common to experience pain and discomfort in the area surrounding the surgical site. You will be prescribed medication to help ease this discomfort as you recover.


Tending to your wound would require extra care. You are advised to carefully follow your surgeon’s instructions to prevent complications or infections during your recovery.


Since open surgery requires a longer recovery process than laparoscopic surgery, do seek advice from your doctor as to when you can resume your regular routine. 


Following a hernia repair, you may be unable to move around naturally for several weeks, and you may be advised to avoid strenuous activities. Additionally, you should avoid carrying and lifting heavy objects during this recovery period. This is to prevent adding stress and strain to the wound.


Due to the nature of a hernia and the cause, heavy lifting should be avoided wherever possible. Weightlifting could potentially cause further herniation and deterioration of your condition so it would be better not to weightlift whilst you have the hernia.


In an article posted on Patient’s Lounge, the author documented her experience managing her femoral hernia.


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