Femoral hernia

What it is

A femoral hernia is a groin hernia that emerges below and lateral to the pubic tubercle, through the femoral canal. The floor of the inguinal canal, formed by the inguinal ligament and the lacunar ligament, is the boundary for the femoral canal. The inguinal canal itself is a 4 cm oblique passage in the lower anterior abdominal wall, from the deep inguinal ring to the superficial inguinal ring, and the superficial ring is a triangular gap in the external oblique aponeurosis above the pubic tubercle. This is what sets a femoral hernia apart from the hernias that take the inguinal canal: indirect hernias enter at the deep ring, an opening in transversalis fascia just above the mid-inguinal point and lateral to the inferior epigastric vessels, while a direct hernia comes from weakness in the posterior wall, which is formed mainly by transversalis fascia and the conjoint tendon.

Causes and risk

Femoral hernias are 4–5× more common in women, not in males.

How it is diagnosed

The place of the sac at the pubic tubercle is what names the hernia. A sac that lies below and lateral to the pubic tubercle at surgery is a femoral hernia, and not an indirect inguinal, a direct inguinal, a Spigelian or an obturator hernia.