Femoral Hernia
A femoral hernia is the other type of “groin hernia”, but is much less common than an inguinal hernia. It can present as a lump in the groin or have more serious complications such as pain, groin swelling, nausea and vomiting related to a bowel blockage (obstruction). Therefore having the correct diagnosis is important and once a femoral hernia has been diagnosed you should see a Hernia Surgeon to discuss the best treatment options.
What is a Femoral Hernia?
A femoral hernia occurs when a hernia lump passes under the inguinal ligament and between the pubic bone and the femoral vein in a tight space that commonly only has lymph nodes and lymphatic channels. A femoral hernia often can have just fat, but more commonly has bowel in it. Unlike an inguinal hernia, once a femoral hernia contains bowel it has a much higher risk of the bowel becoming caught (obstructed or incarcerated femoral hernia) and/or the blood-supply to the bowel in the hernia being cut off (strangulated femoral hernia).
How common is a Femoral Hernia?
A femoral hernia is uncommon and accounts for less than 3% of all hernias. The majority (80%) of femoral hernias occur in people assigned-female-at-birth, they are often thin or have lost weight and, whilst they can occur at any age, they most commonly occur at about 60-70 years of age.
How do Femoral Hernias present?
A lump in the groin is the most common symptom and can present with or without symptoms of obstruction (pain, abdominal distension, nausea and vomiting) or strangulation (progressive pain and swelling of the hernia, change in the skin colour over the hernia). Sometimes symptoms of obstruction with/without strangulation can be the first hint of a femoral hernia and this is diagnosed when you are being investigated for your symptoms.
How is a Femoral Hernia diagnosed?
History and examination can be useful in identifying risk-factors or complications of a femoral hernia, but diagnostic imaging is the best way to confirm a femoral hernia. The two most common imaging techniques for diagnosing a femoral hernia are ultrasound or an abdominal CT-scan. Ultrasound is best used if you have no symptoms of obstruction or strangulation and is helpful to confirm the diagnosis of a hernia and what type of hernia you have. Importantly, if your only symptom is a lump in the groin, an inguinal hernia is still the most common diagnosis! If you have symptoms of obstruction or strangulation, an abdominal CT scan is the best and quickest diagnostic imaging test and gives the surgeon a lot of information about your hernia and the complications it is causing.
What should I do if I have a Femoral Hernia?
If you suspect you have a groin hernia, femoral or inguinal hernia, and you have no symptoms of obstruction or strangulation please see your GP for an initial consultation and referral to a Hernia Surgeon for a more detailed assessment and diagnosis. Once you have been diagnosed with a femoral hernia you should be referred to a Hernia Surgeon to discuss your treatment options.
The only way to fix a femoral hernia is with an operation. Due to the increased risk of complications with a femoral hernia an operation to fix your femoral hernia is most commonly recommended, unless there are extenuating circumstances. There are several types of open and minimally invasive surgery (MIS or “key-hole”) operations depending on your hernia and the presence of any complications. Your Hernia Surgeon will discuss the best surgical option(s) for you and your femoral hernia.
Importantly, if you have a confirmed or suspected Femoral Hernia and symptoms of obstruction and/or strangulation please contact your Hernia Surgeon or present to an Emergency Department for an urgent surgical assessment.