Those that do occur in children are more likely to be associated with a connective tissue disorder or with conditions that increase intra-abdominal pressure.
Seventy percent of pediatric cases of femoral hernias occur in infants under the age of one.
On the other hand, the weakness may be caused by previous surgical incision through the muscles and fascia in the area; this is termed an incisional hernia.
Femoral hernias typically present as a groin lump or bulge, which may differ in size during the day, based on internal pressure variations of the intestine.
Often, they present with a varying degree of complication ranging from irreducibility through intestinal obstruction to frank gangrene of contained bowel.
The cough impulse is often absent and is not relied on solely when making a diagnosis of femoral hernia.
The femoral canal is located below the inguinal ligament on the lateral aspect of the pubic tubercle.
The function of this canal appears to be to allow the femoral vein to expand when necessary to accommodate increased venous return from the leg during periods of activity.
However, in obese patients, imaging in the form of ultrasound, CT, or MRI may aid in the diagnosis.
For example, an abdominal X-ray showing small bowel obstruction in a female patient with a painful groin lump needs no further investigation.
Several other conditions have a similar presentation and must be considered when forming the diagnosis: inguinal hernia, an enlarged femoral lymph node, aneurysm of the femoral artery, dilation of the saphenous vein, athletic pubalgia, and an abscess of the psoas.
[12] Either open or minimally invasive surgery may be performed under general or regional anesthesia, depending on the extent of the intervention needed.
However, emergency repair carries a greater morbidity and mortality rate and this is directly proportional to the degree of bowel compromise.