1.4.5 Femoral hernia

Around 7 % of all hernias are femoral hernias. This special type of inguinal hernia is virtually always acquired and affects mainly women (around 80 % of cases). Risk factors are, in addition to female gender, advanced age, history of pregnancy / pregnancies as well as overweight. The hernia opening of femoral hernias is situated beneath the inguinal ligament in what is known as the lacuna vasorum, which is the entry site for the blood vessels and nerves supplying the thigh.
 
Often, a femoral hernia is diagnosed only at a very late stage, or indeed commonly only when complications are already present. This is due to the fact that the patients concerned feel only a diffuse pressure pain beneath the groin, or indeed no pain at all. In obese patients, in particular, it is often difficult to see or feel a femoral hernia in the form of a swelling below the groin. Hence it is often diagnosed only when the hernial sac is already strangulated within the hernia opening. By that stage, there is a risk of the hernial sac (for example intestinal loops) not being adequately supplied with blood, thus posing a risk of necrosis (tissue death). For that reason a femoral hernia should always be operated on as early as possible.