Femoral hernia pathophysiology: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(31 intermediate revisions by 4 users not shown)
Line 4: Line 4:


==Overview==
==Overview==
A femoral hernia is the protrusion of the [[hernia]] sac through the [[femoral ring]] into the [[femoral canal]]. The [[anatomy]] of the [[femoral canal]] is such that the neck is made up of rigid structures that predispose the herniated [[bowel]] to [[strangulation]] and/or [[Incarcerated hernia|incarceration]]. The [[hernia]] sac contains [[small bowel]] which can predispose to [[intestinal obstruction]]. Some [[connective tissue diseases]] predispose the patient to developing femoral hernia. [[Malignancy]] is very rarely associated with femoral hernias, thus, [[histopathological]] analysis is done routinely following a repair but shows [[Incarcerated hernia|incarcerated]] [[bowel]] on most occasions. 


==Pathophysiology==
==Pathophysiology==


===Anatomy===
===Anatomy===
*Pelvicrural interval, an opening from the abdomen to the thigh is divided in to two spaces:<ref name="pmid17103962">{{cite journal |vauthors=Panton JA |title=Factors bearing upon the Etiology of Femoral Hernia |journal=J. Anat. |volume=57 |issue=Pt 2 |pages=106–46 |year=1923 |pmid=17103962 |pmc=1262989 |doi= |url=}}</ref>
{| align="right"
**Lacuna musculosa (lateral space), as the name suggests the iliopsoas muscles pass through this space.
|
**Lacuna vasculosa (medial space), as the name suggests this is the passage for the femoral vessels.
[[File:Gray546.png|300px|thumb|right|'''Contents of the Femoral Canal'''<br>'''Source:''' Henry Vandyke Carter via Wikimedia Commons<ref name="urlupload.wikimedia.org">{{cite web |url=https://upload.wikimedia.org/wikipedia/commons/7/7d/Gray546.png |title=upload.wikimedia.org |format= |work= |accessdate=}}</ref>]]
*In the pelvis along the anterior surface of the iliopsoas muscle run the external iliac vessels.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref>
|}
*The external iliac vessels pass between the iliopubic tract and Cooper's ligament and then under the inguinal ligament to become the femoral vessels.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref>
*Pelvicrural interval, an opening from the [[abdomen]] to the [[thigh]], is divided into two spaces:<ref name="pmid17103962">{{cite journal |vauthors=Panton JA |title=Factors bearing upon the Etiology of Femoral Hernia |journal=J. Anat. |volume=57 |issue=Pt 2 |pages=106–46 |year=1923 |pmid=17103962 |pmc=1262989 |doi= |url=}}</ref>
*As the external iliac vessels pass along the lacuna vasculosa they are covered by the transversalis fascia forming the femoral sheath.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref>
**Lacuna musculosa ([[lateral]] space), as the name suggests the [[iliopsoas|iliopsoas muscles]] pass through this space.
*The femoral sheath extends 4cm caudally to become the adventitia of the femoral vessels.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref>
**Lacuna vasculosa ([[medial]] space), as the name suggests, is the passage for the [[femoral]] [[vessels]].
*The femoral sheath has a medial compartment that is known as the femoral canal.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref>
*In the [[pelvis]], along the [[anterior surface]] of the [[iliopsoas|iliopsoas muscles]] run the [[external iliac]] [[vessels]].<ref name="Lichtenstein">{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref>
*The femoral canal is less than 2 cm in diameter and it contains lymphatics and glands.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref>
*The [[external iliac]] [[vessels]] pass between the [[iliopubic tract]] and [[Cooper's ligaments|Cooper's ligament]], and then under the [[inguinal ligament]] to become the [[femoral]] [[vessels]].<ref name="Lichtenstein" />
*The true opening of the femoral canal is a musculoaponeurotic ring that consists of:<ref name="pmid4278445">{{cite journal |vauthors=McVay CB |title=The anatomic basis for inguinal and femoral hernioplasty |journal=Surg Gynecol Obstet |volume=139 |issue=6 |pages=931–45 |year=1974 |pmid=4278445 |doi= |url=}}</ref>
*As the [[external iliac]] [[vessels]] pass along the lacuna vasculosa, they are covered by the [[transversalis fascia]] forming the [[femoral sheath]].<ref name="Lichtenstein" />
**Cooper's ligament inferiorly
*The [[femoral sheath]] extends 4cm [[caudally]] to become the [[adventitia]] of the [[femoral]] [[vessels]].<ref name="Lichtenstein" />
**Femoral vein laterally
*The [[femoral sheath]] has a [[medial]] compartment that is known as the [[femoral canal]].<ref name="Lichtenstein" />
**Iliopubic tract superiorly and medially
*The [[femoral canal]] is less than 2 cm in diameter and it contains [[lymphatics]] and [[glands]].<ref name="Lichtenstein" />
*The medial boundary of the femoral ring is made up of the lateral edge of the aponeurosis of the insertion of the transversus abdominus muscle with the transversals fascia onto the pubis.<ref name="pmid4278445">{{cite journal |vauthors=McVay CB |title=The anatomic basis for inguinal and femoral hernioplasty |journal=Surg Gynecol Obstet |volume=139 |issue=6 |pages=931–45 |year=1974 |pmid=4278445 |doi= |url=}}</ref>
*The true opening of the [[femoral canal]] is a musculoaponeurotic ring that consists of:<ref name="pmid4278445">{{cite journal |vauthors=McVay CB |title=The anatomic basis for inguinal and femoral hernioplasty |journal=Surg Gynecol Obstet |volume=139 |issue=6 |pages=931–45 |year=1974 |pmid=4278445 |doi= |url=}}</ref>
*The true inner ring of the femoral canal is bounded:<ref name="pmid14275790">{{cite journal |vauthors=MCVAY CB |title=INGUINAL AND FEMORAL HERNIOPLASTY |journal=Surgery |volume=57 |issue= |pages=615–25 |year=1965 |pmid=14275790 |doi= |url=}}</ref>
**[[Cooper's ligaments|Cooper's ligament]] [[inferiorly]]
**Anteriorly and medially by the iliopubic tract.
**[[Femoral vein]] [[Lateral|laterally]]
**Posteriorly by the Cooper's ligament.
**[[Iliopubic tract]] [[Superior|superiorly]] and [[medially]]
*The distal orifice of the femoral canal has a rigid boundary which is usually less than 1cm in diameter and is surrounded by:<ref>{{cite book | last = Nyhus | first = Lloyd | title = Hernia | publisher = Lippincott | location = Philadelphia | year = 1978 | isbn = 0397503903 }}<ref/><ref name="pmid4280996">{{cite journal |vauthors=Lytle WJ |title=The inguinal and lacunar ligaments |journal=J. Anat. |volume=118 |issue=Pt 2 |pages=241–51 |year=1974 |pmid=4280996 |pmc=1231505 |doi= |url=}}</ref>
*The [[medial]] boundary of the [[femoral ring]] is made up of the lateral edge of the [[transversus abdominis muscle]] [[aponeurosis]] insertion with the [[transversalis fascia]] onto the [[pubis]].<ref name="pmid4278445">{{cite journal |vauthors=McVay CB |title=The anatomic basis for inguinal and femoral hernioplasty |journal=Surg Gynecol Obstet |volume=139 |issue=6 |pages=931–45 |year=1974 |pmid=4278445 |doi= |url=}}</ref>
**The lacunar ligament medially
*The true inner ring of the [[femoral canal]] is bounded by:<ref name="pmid14275790">{{cite journal |vauthors=MCVAY CB |title=INGUINAL AND FEMORAL HERNIOPLASTY |journal=Surgery |volume=57 |issue= |pages=615–25 |year=1965 |pmid=14275790 |doi= |url=}}</ref>
**The inguinal ligament superiorly
**The [[iliopubic tract]] anteriorly and medially
**Fascia of the pectineal muscle  
**The [[Cooper's ligaments|Cooper's ligament]] posteriorly
**The rigidity of these structures is the reason for strangulation in femoral hernias.
*The distal [[orifice]] (neck of the [[femoral canal]]) has a rigid boundary which is usually less than 1 cm in diameter and is surrounded by:<ref name="pmid4280996">{{cite journal |vauthors=Lytle WJ |title=The inguinal and lacunar ligaments |journal=J. Anat. |volume=118 |issue=Pt 2 |pages=241–51 |year=1974 |pmid=4280996 |pmc=1231505 |doi= |url=}}</ref><ref name="pmid18634743">{{cite journal |vauthors=Papanikitas J, Sutcliffe RP, Rohatgi A, Atkinson S |title=Bilateral retrovascular femoral hernia |journal=Ann R Coll Surg Engl |volume=90 |issue=5 |pages=423–4 |year=2008 |pmid=18634743 |pmc=2645754 |doi=10.1308/003588408X301235 |url=}}</ref>
**The [[lacunar ligament]] [[medially]]
**The [[inguinal ligament]] [[Anterior|anteriorly]]
**[[Fascia]] of the [[Pectineus muscle|pectineal muscle]] [[Posterior|posteriorly]]
*The rigidity of the structures forming the boundary of the neck of [[femoral canal]] results in femoral hernias' [[strangulation]].


===Pathogenesis===
===Pathogenesis===
*A femoral hernia is the protrusion of the peritoneal sac through the femoral ring in to the femoral canal posterior and inferior to the inguinal ligament and it is medial to the femoral vessels.<ref>{{cite book | last = Doherty | first = Gerard | title = Current diagnosis & treatment : surgery | publisher = Lange Medical Books/McGraw-Hill | location = New York | year = 2010 | isbn = 978-0071635158 }}</ref>
*A [[femoral hernia]] is the protrusion of the [[peritoneal]] sac through the [[femoral ring]] in to the [[femoral canal]], [[posterior]] and inferior to the [[inguinal ligament]], and it is [[medial]] to the [[femoral]] [[vessels]].<ref name="Doherty">{{cite book | last = Doherty | first = Gerard | title = Current diagnosis & treatment : surgery | publisher = Lange Medical Books/McGraw-Hill | location = New York | year = 2010 | isbn = 978-0071635158 }}</ref>
*The hernia sac can contain preperitoneal fat, omentum or small bowel.
*The [[hernia]] sac may contain preperitoneal [[fat]], [[omentum]] or [[small bowel]].<ref name="Doherty" />
*Femoral hernias typically have a narrow neck, which predisposes them to incarceration and the need for emergent surgery.
*Femoral hernias typically have a narrow [[neck]], which predisposes them to incarceration and the need for emergent surgery.<ref name="Doherty" />
*De Garengeot hernia is a type of femoral hernia that contains the appendix.<ref name="pmid21442431">{{cite journal |vauthors=Phillips AW, Aspinall SR |title=Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia |journal=Hernia |volume=16 |issue=6 |pages=727–9 |year=2012 |pmid=21442431 |doi=10.1007/s10029-011-0812-2 |url=}}</ref>
*De Garengeot [[hernia]] is a type of femoral hernia that contains the [[appendix]].<ref name="pmid21442431">{{cite journal |vauthors=Phillips AW, Aspinall SR |title=Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia |journal=Hernia |volume=16 |issue=6 |pages=727–9 |year=2012 |pmid=21442431 |doi=10.1007/s10029-011-0812-2 |url=}}</ref>
*Littre hernia is an uncommon type of femoral hernia that contain a Meckel's diverticulum.<ref name="pmid21442431">{{cite journal |vauthors=Phillips AW, Aspinall SR |title=Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia |journal=Hernia |volume=16 |issue=6 |pages=727–9 |year=2012 |pmid=21442431 |doi=10.1007/s10029-011-0812-2 |url=}}</ref>
*Littre [[hernia]] is an uncommon type of femoral hernia that contains a [[Meckel's diverticulum]].<ref name="pmid21442431">{{cite journal |vauthors=Phillips AW, Aspinall SR |title=Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia |journal=Hernia |volume=16 |issue=6 |pages=727–9 |year=2012 |pmid=21442431 |doi=10.1007/s10029-011-0812-2 |url=}}</ref>


==Genetics==
==Genetics==
*[Disease name] is transmitted in [mode of genetic transmission] pattern.
*[[First degree relative|First degree relatives]] of patients with [[inguinal hernia]] are more susceptible to developing femoral hernia.<ref name="pmid9225924">{{cite journal |vauthors=Liem MS, van der Graaf Y, Beemer FA, van Vroonhoven TJ |title=Increased risk for inguinal hernia in patients with Ehlers-Danlos syndrome |journal=Surgery |volume=122 |issue=1 |pages=114–5 |year=1997 |pmid=9225924 |doi= |url=}}</ref><ref name="pmid26686553">{{cite journal |vauthors=Jorgenson E, Makki N, Shen L, Chen DC, Tian C, Eckalbar WL, Hinds D, Ahituv N, Avins A |title=A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia |journal=Nat Commun |volume=6 |issue= |pages=10130 |year=2015 |pmid=26686553 |pmc=4703831 |doi=10.1038/ncomms10130 |url=}}</ref>
*Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
*The development of [disease name] is the result of multiple genetic mutations.


==Associated Conditions==
==Associated Conditions==
*[[Ehlers-Danlos syndrome]]<ref name="pmid9225924">{{cite journal |vauthors=Liem MS, van der Graaf Y, Beemer FA, van Vroonhoven TJ |title=Increased risk for inguinal hernia in patients with Ehlers-Danlos syndrome |journal=Surgery |volume=122 |issue=1 |pages=114–5 |year=1997 |pmid=9225924 |doi= |url=}}</ref><ref name="pmid27826465">{{cite journal |vauthors=Harrison B, Sanniec K, Janis JE |title=Collagenopathies-Implications for Abdominal Wall Reconstruction: A Systematic Review |journal=Plast Reconstr Surg Glob Open |volume=4 |issue=10 |pages=e1036 |year=2016 |pmid=27826465 |pmc=5096520 |doi=10.1097/GOX.0000000000001036 |url=}}</ref><ref name="pmid22630060">{{cite journal |vauthors=Lei W, Huang J, Luoshang C |title=New minimally invasive technique for repairing femoral hernias: 3-D patch device through a femoris approach |journal=Can J Surg |volume=55 |issue=3 |pages=177–80 |year=2012 |pmid=22630060 |pmc=3364305 |doi=10.1503/cjs.030710 |url=}}</ref>
*[[Appendicitis]]<ref name="pmid21442431">{{cite journal |vauthors=Phillips AW, Aspinall SR |title=Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia |journal=Hernia |volume=16 |issue=6 |pages=727–9 |year=2012 |pmid=21442431 |doi=10.1007/s10029-011-0812-2 |url=}}</ref><ref name="pmid22983696">{{cite journal |vauthors=Kalles V, Mekras A, Mekras D, Papapanagiotou I, Al-Harethee W, Sotiropoulos G, Liakou P, Kastania A, Piperos T, Mariolis-Sapsakos T |title=De Garengeot's hernia: a comprehensive review |journal=Hernia |volume=17 |issue=2 |pages=177–82 |year=2013 |pmid=22983696 |doi=10.1007/s10029-012-0993-3 |url=}}</ref><ref name="pmid25073217">{{cite journal |vauthors=Snoekx R, Geyskens P |title=De Garengeot's hernia: acute appendicitis in a femoral hernia. Case report and literature overview |journal=Acta Chir. Belg. |volume=114 |issue=2 |pages=149–51 |year=2014 |pmid=25073217 |doi= |url=}}</ref><ref name="pmid28050438">{{cite journal |vauthors=Sinraj AP, Anekal N, Rathnakar SK |title=De Garengeot's Hernia - A Diagnostic and Therapeutic Challenge |journal=J Clin Diagn Res |volume=10 |issue=11 |pages=PD19–PD20 |year=2016 |pmid=28050438 |pmc=5198391 |doi=10.7860/JCDR/2016/21522.8871 |url=}}</ref>
*[[Meckel's diverticulum]]<ref name="pmid18176301">{{cite journal |vauthors=Zacharakis E, Papadopoulos V, Athanasiou T, Ziprin P, Zacharakis E |title=An unusual presentation of Meckel diverticulum as strangulated femoral hernia |journal=South. Med. J. |volume=101 |issue=1 |pages=96–8 |year=2008 |pmid=18176301 |doi=10.1097/SMJ.0b013e31815d3c83 |url=}}</ref><ref name="pmid21442431">{{cite journal |vauthors=Phillips AW, Aspinall SR |title=Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia |journal=Hernia |volume=16 |issue=6 |pages=727–9 |year=2012 |pmid=21442431 |doi=10.1007/s10029-011-0812-2 |url=}}</ref><ref name="pmid25309093">{{cite journal |vauthors=Wu SY, Ho MH, Hsu SD |title=Meckel's diverticulum incarcerated in a transmesocolic internal hernia |journal=World J. Gastroenterol. |volume=20 |issue=37 |pages=13615–9 |year=2014 |pmid=25309093 |pmc=4188914 |doi=10.3748/wjg.v20.i37.13615 |url=}}</ref>
*[[Intestinal obstruction]]<ref name="pmid25309093">{{cite journal |vauthors=Wu SY, Ho MH, Hsu SD |title=Meckel's diverticulum incarcerated in a transmesocolic internal hernia |journal=World J. Gastroenterol. |volume=20 |issue=37 |pages=13615–9 |year=2014 |pmid=25309093 |pmc=4188914 |doi=10.3748/wjg.v20.i37.13615 |url=}}</ref>
*[[Intestinal volvulus]]<ref name="pmid25309093">{{cite journal |vauthors=Wu SY, Ho MH, Hsu SD |title=Meckel's diverticulum incarcerated in a transmesocolic internal hernia |journal=World J. Gastroenterol. |volume=20 |issue=37 |pages=13615–9 |year=2014 |pmid=25309093 |pmc=4188914 |doi=10.3748/wjg.v20.i37.13615 |url=}}</ref>
*[[Intussusception]]<ref name="pmid25309093">{{cite journal |vauthors=Wu SY, Ho MH, Hsu SD |title=Meckel's diverticulum incarcerated in a transmesocolic internal hernia |journal=World J. Gastroenterol. |volume=20 |issue=37 |pages=13615–9 |year=2014 |pmid=25309093 |pmc=4188914 |doi=10.3748/wjg.v20.i37.13615 |url=}}</ref>


==Gross Pathology==
==Gross Pathology==
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*On gross pathology, incarcerated [[bowel]] is a characteristic finding of femoral hernia.<ref name="pmid23794497">{{cite journal |vauthors=Wang T, Vajpeyi R |title=Hernia sacs: is histological examination necessary? |journal=J. Clin. Pathol. |volume=66 |issue=12 |pages=1084–6 |year=2013 |pmid=23794497 |doi=10.1136/jclinpath-2013-201734 |url=}}</ref>


==Microscopic Pathology==
==Microscopic Pathology==
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*It is recommended that femoral hernia specimens should be submitted for [[microscopic]] [[histopathological]] analysis, though it is very rare to find a [[malignant]] lesion in a femoral hernia sac.<ref name="pmid23794497">{{cite journal |vauthors=Wang T, Vajpeyi R |title=Hernia sacs: is histological examination necessary? |journal=J. Clin. Pathol. |volume=66 |issue=12 |pages=1084–6 |year=2013 |pmid=23794497 |doi=10.1136/jclinpath-2013-201734 |url=}}</ref>


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Needs content]]
​​
[[Category:Gastroenterology]]
​​
 
{{WS}}
{{WS}}
{{WH}}
{{WH}}
[[Category:Surgery]]
[[Category:Gastroenterology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]

Latest revision as of 21:44, 29 July 2020

Femoral hernia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Femoral hernia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Femoral hernia pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Femoral hernia pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Femoral hernia pathophysiology

CDC on Femoral hernia pathophysiology

Femoral hernia pathophysiology in the news

Blogs on Femoral hernia pathophysiology

Directions to Hospitals Treating Femoral hernia

Risk calculators and risk factors for Femoral hernia pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]

Overview

A femoral hernia is the protrusion of the hernia sac through the femoral ring into the femoral canal. The anatomy of the femoral canal is such that the neck is made up of rigid structures that predispose the herniated bowel to strangulation and/or incarceration. The hernia sac contains small bowel which can predispose to intestinal obstruction. Some connective tissue diseases predispose the patient to developing femoral hernia. Malignancy is very rarely associated with femoral hernias, thus, histopathological analysis is done routinely following a repair but shows incarcerated bowel on most occasions.

Pathophysiology

Anatomy

Contents of the Femoral Canal
Source: Henry Vandyke Carter via Wikimedia Commons[1]

Pathogenesis

Genetics

Associated Conditions

Gross Pathology

  • On gross pathology, incarcerated bowel is a characteristic finding of femoral hernia.[19]

Microscopic Pathology

References

  1. ↑ "upload.wikimedia.org".
  2. ↑ Panton JA (1923). "Factors bearing upon the Etiology of Femoral Hernia". J. Anat. 57 (Pt 2): 106–46. PMC 1262989. PMID 17103962.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Lichtenstein, Irving (1986). Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies. St. Louis: Ishiyaku EuroAmerica. ISBN 0912791306.
  4. ↑ 4.0 4.1 McVay CB (1974). "The anatomic basis for inguinal and femoral hernioplasty". Surg Gynecol Obstet. 139 (6): 931–45. PMID 4278445.
  5. ↑ MCVAY CB (1965). "INGUINAL AND FEMORAL HERNIOPLASTY". Surgery. 57: 615–25. PMID 14275790.
  6. ↑ Lytle WJ (1974). "The inguinal and lacunar ligaments". J. Anat. 118 (Pt 2): 241–51. PMC 1231505. PMID 4280996.
  7. ↑ Papanikitas J, Sutcliffe RP, Rohatgi A, Atkinson S (2008). "Bilateral retrovascular femoral hernia". Ann R Coll Surg Engl. 90 (5): 423–4. doi:10.1308/003588408X301235. PMC 2645754. PMID 18634743.
  8. ↑ 8.0 8.1 8.2 Doherty, Gerard (2010). Current diagnosis & treatment : surgery. New York: Lange Medical Books/McGraw-Hill. ISBN 978-0071635158.
  9. ↑ 9.0 9.1 9.2 9.3 Phillips AW, Aspinall SR (2012). "Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia". Hernia. 16 (6): 727–9. doi:10.1007/s10029-011-0812-2. PMID 21442431.
  10. ↑ 10.0 10.1 Liem MS, van der Graaf Y, Beemer FA, van Vroonhoven TJ (1997). "Increased risk for inguinal hernia in patients with Ehlers-Danlos syndrome". Surgery. 122 (1): 114–5. PMID 9225924.
  11. ↑ Jorgenson E, Makki N, Shen L, Chen DC, Tian C, Eckalbar WL, Hinds D, Ahituv N, Avins A (2015). "A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia". Nat Commun. 6: 10130. doi:10.1038/ncomms10130. PMC 4703831. PMID 26686553.
  12. ↑ Harrison B, Sanniec K, Janis JE (2016). "Collagenopathies-Implications for Abdominal Wall Reconstruction: A Systematic Review". Plast Reconstr Surg Glob Open. 4 (10): e1036. doi:10.1097/GOX.0000000000001036. PMC 5096520. PMID 27826465.
  13. ↑ Lei W, Huang J, Luoshang C (2012). "New minimally invasive technique for repairing femoral hernias: 3-D patch device through a femoris approach". Can J Surg. 55 (3): 177–80. doi:10.1503/cjs.030710. PMC 3364305. PMID 22630060.
  14. ↑ Kalles V, Mekras A, Mekras D, Papapanagiotou I, Al-Harethee W, Sotiropoulos G, Liakou P, Kastania A, Piperos T, Mariolis-Sapsakos T (2013). "De Garengeot's hernia: a comprehensive review". Hernia. 17 (2): 177–82. doi:10.1007/s10029-012-0993-3. PMID 22983696.
  15. ↑ Snoekx R, Geyskens P (2014). "De Garengeot's hernia: acute appendicitis in a femoral hernia. Case report and literature overview". Acta Chir. Belg. 114 (2): 149–51. PMID 25073217.
  16. ↑ Sinraj AP, Anekal N, Rathnakar SK (2016). "De Garengeot's Hernia - A Diagnostic and Therapeutic Challenge". J Clin Diagn Res. 10 (11): PD19–PD20. doi:10.7860/JCDR/2016/21522.8871. PMC 5198391. PMID 28050438.
  17. ↑ Zacharakis E, Papadopoulos V, Athanasiou T, Ziprin P, Zacharakis E (2008). "An unusual presentation of Meckel diverticulum as strangulated femoral hernia". South. Med. J. 101 (1): 96–8. doi:10.1097/SMJ.0b013e31815d3c83. PMID 18176301.
  18. ↑ 18.0 18.1 18.2 18.3 Wu SY, Ho MH, Hsu SD (2014). "Meckel's diverticulum incarcerated in a transmesocolic internal hernia". World J. Gastroenterol. 20 (37): 13615–9. doi:10.3748/wjg.v20.i37.13615. PMC 4188914. PMID 25309093.
  19. ↑ 19.0 19.1 Wang T, Vajpeyi R (2013). "Hernia sacs: is histological examination necessary?". J. Clin. Pathol. 66 (12): 1084–6. doi:10.1136/jclinpath-2013-201734. PMID 23794497.

​​ ​​ Template:WS Template:WH

Retrieved from "https://www.wikidoc.org/index.php?title=Femoral_hernia_pathophysiology&oldid=1638200"