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Monday, November 26, 2012

Femoral hernia:

Surgical anatomy:

Femoral canal:

It occurs in femoral canal which is most medial compartment of femoral sheath (fold of abdominal fascia) and extends from the femoral ring above to saphenous opening below. It is common in female than male i.e. 2:1.

Contents:

§  Lymph node
§  Fat
§  Lymph vessels

Boundaries of femoral canal:

Anterior: Inguinal ligament
Posterior: Ileopectineal ligament, pubic bone and pectineal fascia
Medial: Lacunar ligament
Laterally: Thin septum separating it from the femoral vein

Clinical features:

o   Swelling (lump) in femoral region (groin)
o   The femoral hernia is below and laterals to pubic tubercle (while inguinal hernia is above and medial to pubic tubercle).

Diagnose:

Clinical examination:

Management:

The same basic rule for hernia repair
·         Reduction of content
·         Excision of excess part of sac
·         Repair of layers
The various procedures are:
Ø  Lockwood (low) operation
Ø  Mcevedy (high) operation
Ø  Lotheissen’s operation
Sometimes there is an abnormal obturator artery medial to Lacunar ligament care must be taken not to injure it.

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