- Incidence: 6.00 cases per 100,000 person-years
- Peak incidence: 70+ years
- Sex ratio: more common in females 2:1
- A lump within the groin, that is usually mildly painful;
- It is important to distinguish femoral hernias, which are inferolateral to the pubic tubercle, from inguinal hernias which are superlateral to the pubic tubercle;
- Typically non-reducible, although can be reducible in a minority of cases;
- Given the small size of the femoral ring, a cough impulse is often absent.
- Femoral artery aneurysm;
- Hydrocoele or varicoele in males;
- Inguinal hernia.
- Refer both men and women with equal urgency;
- Surgical repair is a necessity, given the risk of strangulation, and can be carried out either laparoscopically or via a laparotomy;
- Hernia support belts/trusses should not be used for femoral hernias, again due to the risk of strangulation;
- In an emergency situation, a laparotomy may be the only option.
- Incarceration, where the herniated tissue cannot be reduced;
- Strangulation, which can follow on from incarceration, and is a surgical emergency that requires urgent management (see below). These hernias will be tender and likely non-reducible, and may also present with a systemically unwell patient. The risk of strangulation is much higher with femoral hernias than inguinal hernias and increases as the time from diagnosis rises;
- Bowel obstruction, again a surgical emergency;
- Bowel ischaemia and resection due to the above, which may lead to significant morbidity and mortality for the patient.