FEMORAL HERNIA FEMALE– Case By Dr. Nitin Jadhav

60-year-old-female with right groin bulge for the last few months.

Findings and discussion:

The ultrasound shows herniation of bowel loops and peritoneal fat which is located medial to the common femoral vein and caudal to inferior epigastric vessels. Contents are reducible with compression.

Diagnosis of femoral hernia is made.

Femoral hernia is prone for strangulation.

Key-point in diagnosing femoral hernia: herniated contents are medial to CFV and caudal to inferior epigastric vessels.

Femoral Hernia Ultrasound:

A femoral hernia occurs when intra-abdominal contents, such as fat or bowel loops, protrude through the femoral canal. It is more common in women and can be mistaken for an inguinal hernia or a lymph node.

Ultrasound Findings in Femoral Hernia

1. Herniation of Fat or Bowel Below the Inguinal Ligament:

1. • The key diagnostic feature is the hernia sac protruding below and medial to the femoral vein.
   • The sac may contain hyperechoic fat or hypoechoic bowel loops.

2. Compression and Reducibility:

1. • A reducible femoral hernia will move back into the abdominal cavity with gentle pressure.
   • An irreducible or incarcerated hernia remains unchanged with compression.

3. Vascularity (Doppler Assessment):

1. • Assess flow within the herniated bowel to rule out strangulation.
   • Reduced or absent Doppler signal in bowel loops indicates ischemia, which is a surgical emergency.

4. Differential Diagnosis:

1. • Inguinal Hernia: Above the inguinal ligament and more lateral.
   • Lymph Nodes: Round, non-compressible, with central vascularity.
   • Lipoma: Homogeneous, well-defined, non-reducible, and non-vascular.

Clinical Relevance

• Symptomatic femoral hernias often require surgical repair due to the high risk of incarceration and strangulation.
• Early ultrasound detection can guide management, especially in cases with atypical groin pain.