FEMORAL HERNIAS

Femoral hernias (FH) in the pediatric age are very rare accounting for less than 0.5% of all groin hernias in children. Children present with a recurrent groin lump that is usually reducible. The correct preoperative diagnosis is often overlooked. FH is defined as a protrusion of viscera, fat or omentum occurring through the femoral hiatus. Peak incidence occurs between five and ten years of age. Misdiagnosis includes inguinal hernia, lymphadenitis, and lymphangioma. Preoperative diagnosis is possible if the bulge appears in a location inferior and lateral to that of the commonly occurring indirect hernia. Early recurrence of a groin swelling after what seems to be an adequate inguinal herniorrhaphy should be suspected of having a missed femoral hernia. Mc Vay expressed that the etiology was a congenitally narrow posterior inguinal wall attachment into Cooper's ligament with a resultant enlarged femoral ring. Excision of the sac and repair of the femoral canal is curative. At surgery Cooper's ligament (Mc Vay) repair is the surgical treatment of choice, though some contend that simple repair of the femoral ring carries good long-term results.