Femoral hernia
Groin hernia
A hernia occurs when the contents of the abdomen push through a weak point or tear in the muscle wall of the belly. This layer of muscle holds the abdominal organs in place.
A femoral hernia is a bulge in the upper part of the thigh near the groin.
Inguinal hernia is the result of an organ, usually bowel, protruding through a weak point or tear in the thin muscular abdominal wall. Inguinal hernias can restrict blood supply to the bowel herniated through the defect, creating a medical emergency.
A femoral hernia is a protrusion of a loop of the intestine through a weakened abdominal wall, located in the lower abdomen near the thigh.
Causes
Most of the time, there is no clear cause of a hernia. Some hernias may be present at birth (congenital), but are not noticed until later in life.
Some factors that contribute to the development of a hernia include:
- Chronic constipation
- Chronic cough
- Heavy lifting
- Obesity
- Straining to urinate because of an enlarged prostate
Femoral hernias tend to occur more often in women than in men.
You're lifting a heavy box, when suddenly, you feel a strain in your stomach or groin. If you also feel a bulge there, you might have a hernia. The bump that you feel is a part of what's in your abdomen bulging out through a weak spot in the muscle or tissue that surrounds it. A hernia is kind of like pushing your finger against the side of a balloon. What type of hernia you have depends on where the bulge is located. A femoral hernia is a bulge in the upper part of your thigh. A hiatal hernia is located in the top part of your stomach. An umbilical hernia bulges around your belly button. Inguinal hernias are in the groin area. And incisional hernias usually form around a scar from a past surgery in your abdomen. You can get a hernia if you lift something that's too heavy, or strain too hard while coughing, urinating, or having a bowel movement. Sometimes babies are born with a hernia. That happens when the lining that is supposed to hold the abdominal organs doesn't totally close before birth. Some hernias don't cause any symptoms. You might live with a hernia for a while without even noticing that you have it. Or, you may see an actual bulge in your leg, stomach, or groin. Hernias can sometimes be painful, especially when you strain or lift something heavy. Your doctor should be able to locate the hernia during an exam. If your hernia is small and doesn't bother you, you may not need to do anything but keep in touch with your doctor to make sure it isn't growing. If the hernia is big or painful, your doctor may recommend surgery to plug the opening. The one big risk to having a hernia is that with some types the tissue can get caught inside the hole. This is called strangulation. It can be very dangerous, because blood is cut off to the part of the organ that's trapped. Eventually that tissue will die. If you have a strangulated hernia, you'll need to have emergency surgery. Surgery is the only way to reverse a hernia, although in young children umbilical hernias will often go away on their own. If you have a small hernia and decide not to have surgery, be on the lookout for any changes. Call the doctor right away if you have pain, nausea, vomiting, or a fever, or if your hernia turns red, purple, or another color. These could be signs of strangulation. To avoid a hernia in the first place, be careful when lifting heavy objects. Drink plenty of fluids and add fiber to your diet so you won't have to push too hard on the toilet. And see a urologist if you're straining while urinating.
Symptoms
You may see a bulge in the upper thigh, just below the groin.
Most femoral hernias cause no symptoms. You may have some groin discomfort. It may be worse when you stand, lift heavy objects, or strain.
Sometimes, the first symptoms are:
- Sudden groin or thigh pain
- Abdominal pain
- Nausea
- Vomiting
This may mean that the intestine within the hernia is blocked. This is an emergency.
Exams and Tests
The best way to tell if there is a hernia is to have your health care provider perform a physical exam.
If there is any doubt about the exam findings, an
Treatment
Treatment depends on the symptoms present with the hernia.
If you feel sudden pain in your groin or thigh, a piece of intestine may be stuck in the hernia. This is called an incarcerated hernia. This problem needs treatment right away in an emergency room. You may need emergency surgery.
When you have ongoing discomfort from a femoral hernia, talk to your provider about your treatment choices.
Hernias often get larger as time passes. They do not go away on their own.
Compared to other types of hernias, femoral hernias more commonly have small intestine get stuck in the weak area.
Your surgeon may recommend femoral hernia repair surgery. The surgery is done to avoid a possible medical emergency.
If you do not have surgery right away:
- Increase your fiber intake and drink fluids to avoid constipation.
- Lose weight if you are overweight.
- See your provider if you have trouble urinating (men).
- Use proper lifting techniques.
Outlook (Prognosis)
The chances of a femoral hernia coming back after surgery are low.
If the intestine or other tissue becomes stuck, a portion of the intestine may need to be removed.
When to Contact a Medical Professional
Contact your provider or go to the emergency room right away if:
- You suddenly develop pain in the hernia, and the hernia cannot be pushed back into the abdomen using gentle pressure.
- You develop nausea, vomiting, or abdominal pain.
- Your hernia becomes red, purple, dark, or discolored.
Contact your provider if you have a bulge in the upper thigh next to the groin.
Prevention
It is difficult to prevent hernia. Making changes in your lifestyle can help.
References
Jeyarajah DR, Dunbar KB. Abdominal hernias and gastric volvulus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 27.
Kichler K, Gomez CO, Lo Menzo E, Rosenthal RJ. Abdominal wall and abdominal cavity hernias. In: Floch MH, ed. Netter's Gastroenterology. 3rd ed. Philadelphia, PA: Elsevier; 2020:chap 48.
Poulose BK, Carbonell AM, Rosen MJ. Hernias. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 45.
Reynolds JC, Ward PJ, Rose S, Solomon M. Small bowel. In: Reynolds JC, Ward PJ, Rose S, Solomon M, eds. Netter Collection of Medical Illustrations: Digestive System: Part II - Lower Digestive Tract, The. 2nd ed. Philadelphia, PA: Elsevier; 2017:31-114.
Version Info
Last reviewed on: 8/22/2022
Reviewed by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
