Femoral Hernias
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Laugier’s femoral hernia Narath’s femoral hernia Cloquet’s hernia Hydrocele of the femoral hernia Hydrocele of the femoral hernia Hydrocele of the femoral hernia Hydrocele of the femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia L a u g i e r ’ s f e m o r a l h e r n i a Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Hydrocele of the femoral hernia Hydrocele of the femoral hernia Hydrocele of the femoral hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia Cloquet’s hernia L a u g i e r ’ s f e m o r a l h e r n i a Hydrocele of the femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Laugier’s femoral hernia Hydrocele of the femoral hernia Hydrocele of the femoral hernia Laugier’s femoralhernia Cloquet’s hernia Dr. Mansoor Khan, MBBS, FCPS I, Resident Surgery Dr. Mohammad Zarin, FCPS, MRCS, FMAS Khyber Teaching Hospital Peshawar, Pakistan 2009 8 12
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Transcript of Femoral Hernias
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
Hydrocele of the femoral hernia
Hydrocele of the femoral hernia
Laugier’s femoral hernia
Laugier’s femoral hernia
Laugier’s femoral herniaLaugier’s femoral hernia
Laugier’s femoral herniaLaugier’s femoral hernia
Laugier’s femoral hernia
Laugier’s femoral hernia
Laugier’s femoral hernia
Laugier’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
Cloquet’s hernia
Cloquet’s hernia Cloquet’s hernia
Cloquet’s hernia Cloquet’s hernia
Cloquet’s hernia
Cloquet’s hernia Cloquet’s hernia
Laugier’s femoral hernia
Hydrocele of the femoral hernia
Laugier’s femoral hernia Laugier’s femoral herniaLaugier’s femoral hernia
Laugier’s femoral herniaLaugier’s femoral hernia
Laugier’s femoral herniaLaugier’s femoral hernia
Laugier’s femoral herniaHydrocele of the femoral hernia
Hydrocele of the femoral hernia
Laugier’s femoralhernia
Cloquet’s hernia
Dr. Mansoor Khan, MBBS, FCPS I, Resident Surgery Dr. Mohammad Zarin, FCPS, MRCS,
FMAS Khyber Teaching Hospital Peshawar, Pakistan
2009812
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)
