Femoral hernia

Femoral hernias are a type of groin herniation and comprise a protrusion of a peritoneal sac through the femoral ring into the femoral canal, posterior and inferior to the inguinal ligament. The sac may contain preperitoneal fat, omentum, small bowel, or other structures.

There may be an increased right-sided predilection 2,3. There is an increased prevalence in females 6.

Femoral hernias protrude inferior to the course of the inferior epigastric vessels and medial to the common femoral vein. They often have a narrow funnel-shaped neck and may compress the femoral vein, causing engorgement of distal collateral veins.

Scanning below the inguinal ligament, assessing the space medial to the femoral vein for a hernia. The Valsalva maneuver can be performed to provoke herniation; the common femoral vein should also dilate 6

Femoral hernias typically have a characteristic funnel-shaped neck.

On axial CT images, the neck of the femoral hernia sac may be seen as a narrow protrusion through the femoral ring just medial to the common femoral vein. This can often look indented and compressed by the hernia sac.

Coronal images can also be very useful and it is usually seen in the space containing the fat pad between the inguinal ligament, the common femoral vein and adductor longus 5. Assessment of compression of the femoral vein and any distal engorgement should be made. 

The main differential is made with inguinal hernias. Femoral hernias are more common in women and unlike inguinal hernias, they remain lateral to the pubic tubercle. Femoral hernias invariably compress the femoral vein, while it is rare for an inguinal hernia to compress the femoral vein. 

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Article information

rID: 23937
Tag: hernia
Synonyms or Alternate Spellings:
  • Femoral herniae
  • Femoral hernias
  • Femoral herniation
  • Femoral herniations

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Cases and figures

  • Case 1: right femoral hernia
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  • Case 2: right femoral hernia containing fat
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  • Fat is noted medi...
    Case 3: ultrasound
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  • Case 4: herniography
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  • Case 5: incarcerated causing SBO
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  • Case 6: contains appendix
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  • Case 7
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  • Case 8
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  • Case 9: incarcerated femoral hernia
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  • Case 10
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  • Case 11
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  • Case 12: incarcerated femoral hernia
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  • Case 13
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  • Case 14
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  • Case 15
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  • Case 16
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