Femoral Hernia
A groin bulge near the top of the inner thigh
Quick Facts
- Type: Groin hernia
- Location: Upper inner thigh / groin
- More common in: Women
- Seek urgent care: Sudden painful, firm bulge
Overview
A femoral hernia occurs when fatty tissue or part of the intestine pushes through a weak area in the groin called the femoral canal, near where major blood vessels pass from the abdomen into the leg. It usually appears as a bulge at the top of the inner thigh or in the groin, just below the crease where the leg meets the body.
Femoral hernias are less common than other groin hernias but are more likely to occur in women. Because the femoral canal is narrow, these hernias carry a higher risk of becoming trapped (incarcerated) or having their blood supply cut off (strangulated), which is a surgical emergency. For this reason, femoral hernias are usually repaired with surgery, often promptly after diagnosis.
Symptoms
A femoral hernia may cause few symptoms at first, or it may be noticed as a lump. Possible signs include:
- A bulge in the groin or at the top of the inner thigh
- A lump that may be more noticeable when standing, coughing, or straining
- Aching or discomfort in the groin, especially with activity
Warning signs of a trapped or strangulated hernia include a sudden, painful, firm lump that will not push back, severe groin or abdominal pain, nausea and vomiting, and feeling very unwell. These require emergency care, as the blood supply to trapped intestine can be cut off.
Causes
A femoral hernia forms when there is a weakness in the wall of the femoral canal that allows tissue to push through.
- Weak spot in the groin: The femoral canal is a natural narrow gap that can become a point of weakness.
- Increased abdominal pressure: Straining, heavy lifting, chronic coughing, constipation, or pregnancy can push tissue through the weak area.
The weakness may be present from birth or develop over time. Anything that repeatedly raises the pressure inside the abdomen can contribute to a hernia forming or enlarging.
Risk Factors
- Being female
- Older age
- Pregnancy and childbirth
- Chronic coughing, such as from smoking or lung disease
- Constipation and straining
- Frequent heavy lifting
- Being overweight
Diagnosis
A femoral hernia is usually diagnosed by examination, sometimes with imaging:
- Physical examination: A doctor feels for a bulge in the groin or upper thigh, often asking the person to stand or cough.
- Ultrasound or other imaging: Used when the diagnosis is unclear or to distinguish a femoral hernia from other groin lumps.
- Further tests: If a complication is suspected, additional imaging such as a CT scan may be needed urgently.
Treatment
Because of the higher risk of complications, femoral hernias are usually treated with surgery.
- Surgical repair: The hernia is pushed back and the weak area is strengthened, sometimes using a mesh. This may be done as open surgery or keyhole (laparoscopic) surgery.
- Prompt or planned surgery: Repair is often advised soon after diagnosis to reduce the risk of the hernia becoming trapped.
- Emergency surgery: Needed if the hernia becomes incarcerated or strangulated, to relieve the obstruction and check the blood supply to the intestine.
Most people recover well after repair, with the timing depending on the type of surgery.
Prevention
- Maintain a healthy weight
- Eat enough fiber and stay hydrated to avoid constipation and straining
- Lift heavy objects with good technique, using the legs rather than the back
- Treat a persistent cough and avoid smoking
- Seek evaluation early for any new groin bulge
When to See a Doctor
See a doctor if you notice a lump or bulge in your groin or upper thigh, even if it is not painful, so it can be assessed. Seek emergency care immediately if you have:
- A sudden, painful, firm bulge that cannot be pushed back
- Severe groin or abdominal pain
- Nausea and vomiting
- Redness over the bulge or feeling very unwell
These can mean the hernia is strangulated and the trapped tissue is losing its blood supply, which is a surgical emergency.
Frequently Asked Questions
What is a femoral hernia?
It is a bulge that forms when tissue or part of the intestine pushes through a weak area in the groin called the femoral canal, near the top of the inner thigh. It is a type of groin hernia and is more common in women.
Why do femoral hernias often need surgery?
The femoral canal is narrow, so these hernias have a higher risk of becoming trapped or having their blood supply cut off (strangulation), which is dangerous. Surgery is usually advised, often soon after diagnosis, to prevent this.
How can I tell a femoral hernia from another groin lump?
It can be hard to tell by yourself, so any new groin lump should be examined by a doctor. An ultrasound or other imaging may be used to confirm the diagnosis and rule out other causes.
When is a femoral hernia an emergency?
Seek emergency care if the bulge becomes suddenly painful, firm, and cannot be pushed back, or if you have severe pain, nausea, and vomiting. These can signal a strangulated hernia, which needs urgent surgery.
What is recovery like after femoral hernia surgery?
Most people recover well. Recovery time depends on whether open or keyhole surgery is used and on individual health, but many return to light activity within a couple of weeks following their surgeon's advice.
References
- Mayo Clinic. Inguinal and other groin hernias.
- MedlinePlus, U.S. National Library of Medicine. Hernia.
- National Health Service (NHS). Femoral hernia repair.
- American College of Surgeons. Hernia Repair.