Femoral hernia on ultrasound: peritoneal fluid and fat herni | Figure 1

%27%3e%3cg%20id=%27Group-14%27%20transform=%27translate(13.000000,%20103.176124)%27%3e%3cg%20id=%27Group-Copy-5%27%20transform=%27translate(0.000000,%20182.676124)%27%3e%3crect%20id=%27Rectangle-8%27%20fill=%27%23E2E0DE%27%20x=%270%27%20y=%270%27%20width=%2736%27%20height=%2736%27%20rx=%2718%27%3e%3c/rect%3e%3cpath%20d=%27M28,27.6503435%20C28,22.127496%2023.5228474,17.6503435%2018,17.6503435%20C12.4771525,17.6503435%208,22.127496%208,27.6503435%20M18,16.3472505%20C20.8165136,16.3472505%2023.099749,14.0640151%2023.099749,11.2475015%20C23.099749,8.43098783%2020.8165136,6.1477524%2018,6.1477524%20C15.1834863,6.1477524%2012.9002509,8.43098783%2012.9002509,11.2475015%20C12.9002509,14.0640151%2015.1834863,16.3472505%2018,16.3472505%20Z%27%20id=%27Combined-Shape%27%20fill=%27%23FFFFFF%27%20fill-rule=%27nonzero%27%3e%3c/path%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/svg%3e)

Femoral hernia on ultrasound: peritoneal fluid and fat herniated through femoral canal. #1-2 axial plane. #3-4 sagittal plane. Red: femoral artery. Blue: femoral vein. Brown: hernia sac. Green: fascial line.

Case Description

A 74-year-old female with a known history of an inguinal hernia, currently undergoing preoperative evaluation, presented to the emergency department with acute-onset pain in the right groin. The patient reported associated nausea, vomiting, and inability to pass flatus or stool.
Physical Examination
Examination revealed a non-reducible, exquisitely tender mass located below and lateral to the pubic tubercle. Abdominal distension and hyperactive bowel sounds were noted, suggesting intestinal obstruction.
Ultrasound Findings
The ultrasound showed a 15 mm hernial sac protruding through the femoral canal containing an incarcerated small bowel loop. The bowel wall was thickened to 4 mm with minimal free fluid in the sac and absent peristalsis in the herniated segment.
Diagnosis
Incarcerated femoral hernia with secondary mechanical small bowel obstruction.
Surgical Intervention and Outcome
The patient underwent an urgent Transabdominal Preperitoneal (TAPP) laparoscopic repair. Intraoperatively, the femoral hernia was reduced. The incarcerated ileal segment showed initial ischemia but regained normal perfusion, color, and peristalsis after 10 minutes of warm saline application, confirming viability.
No bowel resection was required and the surgical field remained clean without contamination. A large 3DMax mesh was placed to cover the myopectineal orifice and secured using Glubran 2 adhesive. The patient had an unremarkable recovery and was discharged on postoperative day two.

Related Cases

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.

Femoral hernia. 26 YO female patient.

Femoral hernia - note the inguinal ligament isolated above the hernia #hernia #surgery

Femoral hernia repair with mesh plug #hernia #surgery

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history.