Femoral hernia

1. 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
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
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
Laugier’s 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
Laugier’s femoral hernia
Laugier’s femoral hernia
Hydrocele of the femoral hernia
Hydrocele of the femoral hernia
Laugier’s femoralhernia
Cloquet’s HERNIA

MansoorKhan
20106
01

2. “Protrusion of a viscus or part of a viscus
through an abnormal opening in the wall of its
containing cavity”

3. ETIOLOG
Y

4. :
Hernialsac
diverticulum of the peritonium (mouth, neck, body,
fundus)

5. NECK
BODY
FUNDUS

6. Coverings: derived form the layers of the abdominal wall

7. Contents: omentum, intestine, portion of a viscus,
appendix, meckel’s diverticulum, bladder
Sliding Hernia Fallopian tube
Omentocele
Enterocele

8. :
Reducible
contents can be reduced back to abdominal cavity

9. :
Irreducible
contents can not be
reduced to the abdominal cavity—
risk of strangulation

10. :
Strangulated
blood supply to the contents is
compromised leading to gangrene in 6 hours
—emergency

11. :
Obstructed
the bowel lumen is obstructed
without compromise of blood supply—usually
go on to strangulation

12. Anatomy of inguinal canal

13. indirect inguinal hernia most common hernia. Most common
in young. Direct hernia is most common in elderly. In adults
65% are indirect hernia, in 55% on right side

14. Ingiunial hernia in babies is due to patent processus
vaginalis

15. Funicular Bubonocele Testicular

16. What is a femoral
hernia?

17. A femoral hernia is when abdominal
Contents pass through a naturally
occurring weakness called
the femoral canal.

18. 3
rd
Most common
primary hernia
20%
female
hernias
5%
of male
hernias
2
t i m e s m o r e c o m m o n
o n r i g h t s i d e
20%
cases it is
bilateral

19. Over-riding
importance of
femoral hernia..??

20. Strangulation
narrowness and rigidity
of the canal– 40%
present as strangulation
Truss does not help---
contraindicated

21. Femoral
Canal……
?

22. 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)

23. Femoral
ring……
?

24. Lateral---
Femoral vein in
femoral sheath
Medial---
Lacunar
ligament
(Gimbernat’s)
Anterior– Inguinal
ligament (Poupart)
Posterior– Iliopectineal
ligament (Astley Cooper’s)

F
e
m
o
r a
l
r i n
g

25. Elderly, multi-parous
women
Dragging pain & groin
lump
40% present with
strangulation
Rare before puberty

26. Femoral hernia

27. Bilateral femoral
hernia

28. Differential
diagnosis..
?

29. Inguinal hernia superio-medial while
femoral is inferiolateral to pubic
tubercle

Inguinalhernia

Femoralhernia

30. :
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

31. Types of femoral
hernia…?

32. Hydrocele of the femoral hernia
sac when neck is blocked by
contents or adhesions

33. Laugier’s femoral hernia
Hernia through the lacunar
ligament of Gimbernat’s

34. Narath’s femoral hernia
sac behind the femoral vessels,
occurs in hip dislocation

35. Cloquet’s hernia
sac behind the pectineal fascia

36. Think as a
Surgeon…
WHEN TREATING FEMORAL
HERNIA

37. Hurry up you got some
work to do man….

38. Operate as soon as
diagnosis is made--
strangulation

39. Remember Truss is
contraindicated…..

40. High operation (McEvedy)

41. Low operation (Lockwood)

42. Inguinal operation
(Lotheissen’s)

43. Laparoscopic repair (TEP—total extra-peritoneal)