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Femoral hernia
Definition
A hernia occurs when the contents of the abdomen (usually part of the small intestine) push through a weak point or tear the thin muscular wall of the belly, which holds the abdominal organs in place.
A femoral hernia is a bulge in the upper part of the thigh near the groin.
Alternative Names
Femorocele; Enteromerocele; Crural hernia
Causes
Most of the time, there is no clear cause of a hernia. Some hernias may be present at birth (congenital), but are not noticed until later in life.
Some factors that contribute to the development of a hernia include:
- Chronic constipation
- Chronic cough
- Heavy lifting
- Obesity
- Straining to urinate because of an enlarged prostate
Femoral hernias tend to occur more often in women than in men.
Symptoms
You may see a bulge in the upper thigh just below the groin.
Most femoral hernias cause no symptoms. There may be some groin discomfort that is worse when you stand, lift heavy objects, or strain.
Sometimes, the first symptoms are sudden groin pain, abdominal pain, nausea, or vomiting. This may mean that the intestine within the hernia is blocked. This is an emergency.
Exams and Tests
The best way to tell if there is a hernia is to have your health care provider perform a physical exam.
If there is any doubt about the exam findings, an ultrasound or CT scan may be helpful.
Treatment
Treatment depends on the symptoms present with the hernia.
If you feel sudden pain in your groin, a piece of intestine may be stuck in the hernia (called an incarcerated hernia). This needs treatment right away in a hospital emergency room, and you may need emergency surgery.
When you have chronic discomfort from a femoral hernia, talk to your health care provider about treatment choices.
- Hernias often get larger with time, and they do not go away on their own.
- Femoral hernias are more commonly incarcerate compared to other types of hernias.
Your surgeon may recommend femoral hernia repair surgery to avoid a possible medical emergency.
If you do not have surgery right away:
- Increase your fiber intake and drink fluids to avoid constipation.
- Lose weight if you are overweight.
- See your health care provider if you have trouble urinating (men).
- Use proper lifting techniques.
Outlook (Prognosis)
The chances of a femoral hernia coming back after surgery are about low.
If the intestine or other tissue becomes stuck, a portion of the intestine may need to be removed.
When to Contact a Medical Professional
Call your health care provider or local emergency number (911) or go to the emergency room right away if:
- You suddenly develop pain in the hernia and the hernia cannot be pushed back into the abdomen using gentle pressure.
- You develop nausea, vomiting, or abdominal pain.
- Your hernia becomes red, purple, dark, or discolored.
Call your health care provider for an appointment or advice if you have a bulge in the upper thigh next to the groin.
Prevention
References
Malangoni MA, Rosen MJ. Hernias. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 46.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Joshua Kunin, MD, Consulting Colorectal Surgeon, Zichron Yaakov, Israel. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Inc.
