Incarcerated femoral hernia

Case contributed by Dr Ian Bickle

Presentation

Elderly male patient with large red tender lump of short duration around the right mons pubis. Abscess?

Patient Data

Age: 82
Gender: Male
CT

Non contrast due to renal impairment.

Gaseous structure in the right femoral region with multiple small surrounding satellite foci of gas.

This is continuity through a small 'funnel shaped' neck with a loop of non distended distal small bowel.  This lies medial to the femoral vessels.

Couple of tiny foci of free gas in the right iliac fossa.

Gallstones.

Left basal lung inflammatory changes.

Case Discussion

Femoral hernia occur almost exclusively in the female.

In this case there was genuine clinical confusion.  A portable ultrasound didn't indicate an abscess and indicated gas, but no peristalsis to indicate a loop of bowel in the groin.

The narrow neck indicates incarceration of the hernia which contains small bowel, with the gas in the hernia suggestive of ischaemia and perforation.

An incarcerated right femoral hernia with ischaemic perforated small bowel as identified and treated at surgery.

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Case information

rID: 48106
Case created: 19th Sep 2016
Last edited: 19th Sep 2016
Inclusion in quiz mode: Included

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