Two Cases of Femoral Hernia in Children

Abstract

Femoral hernia is very rare in children and the incidence is between 0.01 and 0.9% in children with inguinal hernia. We report two cases of femoral hernia in childhood. Case 1: A four-year-old boy was referred to us, complaining of left inguinal swelling. He was diagnosed with femoral hernia on the left side because the swelling was located outside the inguinal canal. At operation, the hernia sac was not found in the inguinal canal, but it was located laterally and inferiorly to the inguinal canal through the left femoral canal. There was no content in the hernia sac. The Cooper's ligament was sutured to the pectineal fascia through a femoral approach after the hernia sac was inverted into the peritoneal cavity with a good result. Case 2: A two-year-old girl was emergently admitted to us with a diagnosis of left irreducible inguinal hernia. She was diagnosed as having an irreducible femoral hernia on the left side because the swelling was located outside the inguinal canal as in case 1. She was operated on immediately; the hernia sac was found latero-inferiorly to the inguinal canal through the left femoral canal as in case 1. The hernia content was the omentum. The omentum was reduced into the peritoneal cavity and the hernia sac was simply ligated with a good outcome. We should consider a femoral hernia or a direct hernia, when intraoperative findings do not correspond to the preoperative diagnosis of indirect inguinal hernia. As for the surgical treatment, the optimal procedure for a femoral hernia still remains controversial.