Femoral hernia is also known as enteromerocele, crural hernia and femorocele.
Hernia is a condition that occurs when the contents of the abdomen, generally a part of the small intestine, is pushed down from a weak point in the muscular wall or tear in the thin muscular wall of the abdomen that is responsible for holding the abdominal organs to keep them in their place.
Femoral hernia is a condition that occurs when the contents of the abdomen are pushed down from the femoral canal resulting in formation of bulge in the upper thigh which is located near the groin. About 10 percent of hernia cases are estimated to be femoral hernias. Performing exercises in femoral hernia not only results in pain that largely depends upon the movements, but also aggravates the condition by worsening it.
Femoral hernia is more common in women when compared to men. Femoral hernia often results from being overweight or obese, lifting heavy objects related to daily tasks and exercise, chronic constipation and frequent and chronic coughing. Femoral hernia often does not exhibit any symptoms however bulge near the groin is noticeable. Total intestinal blockage and strangulation may result in nausea, vomiting and abdominal pain in which case the patient needs to be shifted to emergency room immediately.
Some of the femoral hernias may be congenital or are present at birth, but may go unnoticed until later in life.
Classification and Types of Femoral Hernia
Femoral hernia is broadly classified into four types:
- Reducible femoral hernia.
- Irreducible femoral hernia.
- Strangulated irreducible femoral hernia.
- Incarcerated femoral hernia.
Reducible Femoral Hernia: Reducible femoral hernia is a condition in which the hernia can be manipulated manually back into the abdominal cavity. The intestine can be pushed back inside the cavity so that the opening heals on its own and creates no more problems.
Irreducible Femoral Hernia: An irreducible femoral hernia is a condition in which external manipulation does not help in correction of hernia.
Strangulated Irreducible Femoral Hernia: A strangulated irreducible femoral hernia is a condition in which the herniated segment of the intestine has twisted, compromising the blood flow and function of the intestine. A strangulated irreducible femoral hernia is a serious condition and needs to be addressed immediately.
Incarcerated Femoral Hernia: Incarcerated femoral hernia is a condition where a piece of intestine may be stuck in the hernia. Incarcerated femoral hernia is also a serious condition and needs to be addressed immediately.
Causes and Risk Factors of Femoral Hernia
Although in many cases it is difficult to find out the exact cause of femoral hernia, however suspected causes may include:
- Heavy lifting.
- Straining hard during urination, probably due to enlarged prostate.
- Chronic constipation.
- Females often get affected.
- Chronic cough.
Signs and Symptoms of Femoral Hernia
Although in many cases femoral hernia does not exhibit any symptoms, but there are some reasons and experiences that help in indicating the symptoms.
- Appearance of a bulge in the upper thigh near the groin.
- Abdominal pain.
- Groin discomfort that becomes worse while straining, standing and lifting heavy objects.
Treatment for Femoral Hernia
Treatment options of femoral hernia depend upon the symptoms. All the femoral hernias present as a bulge roughly in the mid-thigh or just below the inguinal fold. Thorough examination needs to be done to check if the femoral hernia can be manipulated externally to relocate it back into its correct place or if it needs to be corrected surgically.
Femoral hernias are more commonly found to be incarcerated when compared to other types of hernias hence they need to be addressed surgically to avoid any medical emergency, as if left untreated this incarcerated tissue may die off. Surgery helps in relieving this discomfort. Surgical repair involves placing back the herniated content into place and repairing the defect in the abdominal wall. The area is either stitched or a piece of plastic mesh known as hernia patch is placed surgically in order to repair the defect present in the abdominal wall to prevent recurrence of hernia.
This surgery is a minor surgery and does not involve lot of risks, however it may carry the risks, as is the case with other surgeries, of infection and reaction to pain medications.
Following steps can be taken for prevention of femoral hernia:
- Avoiding constipation by increasing fiber intake and drinking sufficient fluid.
- Maintaining a healthy body weight.
- Putting too much stress on the abdominal wall must be avoided.
- Straining while urinating or defecating must be avoided.
- Lifting heavy objects must be avoided.
Should One Exercise If Having Femoral Hernia?
Performing exercises when affected with femoral hernia must be strictly avoided. Exercises that help in emphasizing the abdominal muscles are specifically bad as they are often responsible for straining a hernia. Exercises may also result in strangulation which is often suffered in femoral hernia. Exercises are not a safe option however walking and swimming are kind of exercises that carry less issues.
Investigations To Diagnose Femoral Hernia
Generally a complete subjective, objective and physical examination is performed to diagnose femoral hernia.
Other tests that help in diagnosing and assessing the severity may include:
- CT scan.