femoral hernia

Laugier’s femoral hernia

Narath’s femoral hernia

Cloquet’s hernia

Hyd

roce

le o

f th

e fe

mor

al h

erni

a

Hydrocele of the femoral hernia





Laugier’s femoral herniaLaugier’s femoral hernia






Hydrocele of the femoral herniaHydrocele of the femoral hernia

Hyd

roce

le o

f th

e fe

mor

al h

erni

a

Cloquet’s hernia Cloquet’s hernia


Cloquet’s hernia



Cloquet’s hernia




Laugier’s femoral hernia Laugier’s femoral herniaLaugier’s femoral hernia



Laugier’s femoral herniaHydrocele of the femoral hernia


Laugier’s femoralhernia

Cloquet’s HERNIA

Mansoor Khan

2010601

“Protrusion of a viscus or part of a viscus through an abnormal opening in the wall of its

containing cavity”

ETIOLOGY

Hernial sac: diverticulum of the peritonium (mouth, neck, body, fundus)

NECK

BODY

FUNDUS

Coverings: derived form the layers of the abdominal wall

Contents: omentum, intestine, portion of a viscus, appendix, meckel’s diverticulum, bladder

Sliding HerniaFallopian tube

Omentocele

Enterocele

Reducible: contents can be reduced back to abdominal cavity

Irreducible: contents can not be reduced to the abdominal cavity—risk of strangulation

Strangulated: blood supply to the contents is compromised leading to gangrene in 6 hours—emergency

Obstructed: the bowel lumen is obstructed without compromise of blood supply—usually go on to strangulation

Anatomy of inguinal canal

indirect inguinal hernia most common hernia. Most common in young. Direct hernia is most common in elderly. In adults

65% are indirect hernia, in 55% on right side

Ingiunial hernia in babies is due to patent processus vaginalis

FunicularBubonocele Testicular

What is a femoral hernia?

A femoral hernia is when abdominal Contents pass through a naturally

occurring weakness called the femoral canal.

3rdMost common

primary hernia

20%female

hernias

5%of m

ale

hernias

2tim

es more

com

mon

on right s

ide

20%cases it is

bilateral

Over-riding importance of

femoral hernia..??

Strangulation narrowness and rigidity

of the canal– 40% present as

strangulation

Truss does not help--- contraindicated

Femoral Canal……

?

Potential space in medial portion of femoral sheath

1.25 cm long

1.25 cm wide

Femoral ring

covered by septum

crurale (above)

Saphenous opening covered by cribriform fascia (below)

Femoral ring……

?

Lateral---

Femoral vein in femoral

sheath

Medial---

Lacunar ligament

(Gimbernat’s)

Anterior–

Inguinal ligament (Poupart)

Posterior–

Iliopectineal ligament (Astley Cooper’s)

Fem

oral

ring

Elderly, multi-parous women

Dragging pain & groin lump

40% present with strangulation

Rare before puberty

Femoral hernia

Bilateral femoral hernia

Differential diagnosis..

?

Inguinal hernia superio-medial while femoral is inferiolateral to pubic tubercle

Inguinal hernia

Femoral hernia

Saphena varex: positive cough impulse make them similar, fluid thrill, hum on auscultation, disappearance when supine and presence of varicose veins differentiates it from femoral hernia

Types of femoral

hernia…?

Hydrocele of the femoral herniasac when neck is blocked by

contents or adhesions

Laugier’s femoral herniaHernia through the lacunar

ligament of Gimbernat’s

Narath’s femoral hernia sac behind the femoral vessels,

occurs in hip dislocation

Cloquet’s hernia sac behind the pectineal fascia

Think as a Surgeon…

WHEN TREATING FEMORAL HERNIA

Hurry up you got some work to do

man….

Operate as soon as diagnosis is made--

strangulation

Remember Truss is contraindicated…..

High operation (McEvedy)

Low operation (Lockwood)

Inguinal operation

(Lotheissen’s)

Laparoscopic repair (TEP—total extra-peritoneal)

femoral hernia

Health & Medicine