A femoral hernia is a rupture of the intestines. It occurs below the inguinal ligament and is noticeable with pain that does not necessarily indicate the injured region. For example, the symptoms can initially affect the thigh. A femoral hernia must always be treated surgically.
What is femoral hernia?
In the context of a femoral hernia, a hernial sac protrudes through a point in the tissue. Especially when the pressure is increased, the femoral hernia in the abdomen can not only be felt, but often also seen. The fracture itself is made up of various elements. These include a hernial orifice, hernial sac and the contents of the hernia. A femoral hernia manifests itself as a hernial opening that is no more than one centimeter in size. See deluxesurveillance for Leber’s Optic Atrophy Guide.
It can be located under the inguinal ligament. Because parts of the intestine can be found in the hernial sac, a femoral hernia always has to be operated on. Otherwise, the bowel can become trapped between the structures, which would result in further problems. Overall, women are more likely to suffer from a femoral hernia than men. In 40 percent of the patients, sections of the intestine that are already pinched can be found during the making of the diagnosis.
Another hernia can occur at the same time as a femoral hernia. Such a phenomenon occurs in about 50 percent of all patients. Not only is there a femoral hernia, but also an inguinal hernia.
Causes
The cause of the femoral hernia can be found in a weak spot in the tissue within the abdominal wall. The abdominal wall is stabilized by various structures such as fascia and aponeuroses. However, the groin region is not supported everywhere and evenly. Instead, some sites show a lack of aponeuroses and muscles. These are therefore inherently more susceptible to a hernia and can be understood as a natural weak point.
Such a fracture occurs in the context of the femoral hernia on the back of the inguinal ligament. With increasing pressure and weak connective tissue occurring at the same time, a femoral hernia can eventually occur. According to experts, there are several factors that favor the occurrence of such a phenomenon. These include, for example, more frequent pregnancies, existing obesity and collagen weakness that develops with advancing age.
Some other disorders are characterized by collagen weakness, such as Marfan syndrome. After groin surgery, certain procedures used can also increase the likelihood.
Symptoms, Ailments & Signs
A femoral hernia does not always cause symptoms. If a patient suffers from pain, this often cannot be directly attributed to a femoral hernia, instead it radiates into the thigh, for example. Swelling can be noticeable, especially with heavy exertion. If the hernial sac is already pinched, pain can occur that is limited to the groin, abdomen, and inner thighs.
Such ailments often result from the fact that the affected structures are subjected to movement. In women in particular, it cannot be ruled out that the ovaries will also lose their position as a result of the femoral hernia. A femoral hernia is always acquired. In most cases, women are affected. In men, the symptoms occur particularly after an operation in the groin area.
Diagnosis & course of disease
Swelling in the performance area below the inguinal ligament should always be checked out by a doctor. Such an appearance may indicate a femoral hernia. Before the physical examination, there is a detailed discussion with the doctor. Information about the period of the complaints, previous operations and any concomitant diseases should be provided here.
Whether a femoral hernia is present can usually be determined during a palpation examination. This is done both sitting and standing. As soon as the patient tenses and presses the structures, the hernial sac can be felt. If you are overweight, the palpation test sometimes proves to be difficult. This is where an ultrasound can help.
Complications
First and foremost, those affected by this disease suffer from severe pain. The pain occurs in the thigh area and can also radiate into the entire leg. This also leads to severe restrictions in movement and also to restrictions in everyday life. In many cases, unfortunately, treatment is delayed because the disease does not show any characteristic symptoms.
Due to the permanent pain, the development of the child may also be impaired, so that the patient develops complaints in adulthood. Other complaints usually do not occur. Pain at rest can lead to trouble sleeping at night, which can lead to irritability and psychological problems in the patient. Femoral hernias are usually treated with a surgical procedure.
There are no particular complications. This relieves the symptoms and completely defeats the disease. In most cases, the affected person does not suffer from any further limitations in movement after the procedure. The patient’s life expectancy is also not negatively affected by the femoral hernia. If there is no treatment, the tissue of the intestine may also be injured.
When should you go to the doctor?
A femoral hernia often proceeds initially without clear symptoms. A visit to the doctor is recommended if the typical pain in the groin area occurs. The symptoms usually become noticeable during physical exertion and can radiate into the thighs. Affected people should have the symptoms examined by their family doctor. If the pain increases rapidly or is accompanied by other symptoms, it is best to consult a doctor immediately. If risk factors such as advanced age, weak connective tissue or pregnancy are present, the doctor must be involved.
Severe obesity and a chronic cough can also trigger a femoral hernia due to persistent pressure on the intestines. Anyone who belongs to the risk groups must pay attention to any signs of illness and, if in doubt, speak to their family doctor. A femoral hernia is treated by the general practitioner, an internist, or a gastroenterologist. Depending on the symptoms, other specialists can be consulted.
If the thigh fracture is recognized and operated on early, the symptoms should subside after a few weeks. Close consultation with the doctor during aftercare helps to clarify any side effects. Children who show signs of a femoral fracture must be taken to the pediatrician. In the case of severe symptoms that quickly intensify, the emergency services should be consulted.
Treatment & Therapy
Because the organs do not regress on their own, surgery is always required for a femoral hernia. Otherwise there would be a risk that the intestine would become trapped in the hernial orifice and the tissue would be injured. A distinction can be made between different surgical methods. On the one hand, an open operation can be performed, on the other hand, a minimally invasive one using the keyhole technique.
In the last method, surgical use is made through a small incision in the tissue. During open surgery, the doctor opens the hernial sac. The procedure can start either in the groin area or in the thigh area. After the hernial sac has been removed, the other structures are pushed into their original position and the hernial orifice and wound are then closed. An isolated operation is performed without opening the inguinal canal. Instead, the incision begins near the inguinal ligament.
After the structures have been pushed back, the hernial orifice is closed with a suture. A closed surgical insert is considered to be particularly gentle. However, it can only be used under certain conditions. The doctor makes small incisions through which he inserts his surgical instruments. A laparoscope helps to maintain orientation. In order to stabilize the hernia orifice of the femoral hernia, the use of a plastic mesh is recommended.
Prevention
A femoral hernia can only be prevented to a limited extent. Ultimately, a reduced collagen content is a natural sign of aging. However, repeated births and obesity seem to increase the risk. Accordingly, excess pounds should be reduced and attention should be paid to a healthy diet.
Aftercare
After the hernia operation, patients can usually leave the clinic after one to seven days. The suture material is removed after four to ten days. Showering is possible within two days, bathing and direct sunlight on the scars should be avoided for around two weeks.
The exception is large incisional hernias, for which wearing an abdominal bandage for three months is recommended. Patients should rest physically for about two to three weeks after the operation. During this time, they should refrain from exertion that goes beyond the simple activities of daily living, such as personal hygiene and housework.
This is followed by a slow increase in physical exertion. Depending on the type of activity, work can be resumed after around three weeks, and the first sporting activities can take place after four weeks. Weights of more than ten kilograms can only be lifted safely after six weeks. Up to 14 days after the surgical procedure, wound pain can be expected, which can be treated well with painkillers.
If the symptoms persist, a doctor should be consulted. During the healing phase, overexertion in the groin area, such as that which occurs when you strain too hard during a bowel movement, should be avoided. Taking mild laxatives is recommended for relief.
You can do that yourself
In the case of a femoral hernia, the affected person always needs medical help and support. The possibilities of self-help are not enough to achieve relief or recovery. The patient should maintain close cooperation with the treating physician.
Since an operation is necessary, strengthening the body’s own defense system helps with rapid and effective healing. In order to support the wound healing process as best as possible, a balanced and healthy diet is important. The organism needs a stable immune system in order to be able to defend itself against possible pathogens or germs. Adequate oxygenation and exercise also strengthen the body. In order for the organism to be able to regenerate optimally, it is advisable to take sufficient breaks and observe good sleep hygiene. Overexertion, physical strain or stress should be avoided or reduced.
Since the disease can cause complications that are associated with restricted mobility, poor posture and one-sided physical strain should be corrected early in everyday life. To do this, attention must be paid to the movement sequences and rigid postures should only be adopted for a short time. Muscle problems or tension can be reduced by balancing movements. Physiotherapeutic exercises are recommended to alleviate the symptoms. In addition, sufficient heat and massage help to prevent muscular irregularities.
