Femoral hernia in children: How to avoid misdiagnosis?
Children
femoral hernia
inguinal hernia
paediatric surgery
Journal
African journal of paediatric surgery : AJPS
ISSN: 0974-5998
Titre abrégé: Afr J Paediatr Surg
Pays: India
ID NLM: 101255062
Informations de publication
Date de publication:
Historique:
entrez:
3
8
2021
pubmed:
4
8
2021
medline:
20
8
2021
Statut:
ppublish
Résumé
Femoral hernias are an uncommon groin pathology among pediatric patients. Therefore, they are frequently misdiagnosed. In the present study, we review our experience with this rare surgical entity during the past 25 years. The medical records of 19 patients who underwent 22 femoral hernia repairs between January 1994 and December 2019 were retrospectively analysed. Patients' age ranged from 2 to 12 years (mean age was 5. 5 years) with an approximately equal sex ratio (10 girls/9 boys). There were three bilateral cases identified separately. They were discovered and managed at different times. All the children were referred with a groin lump, but the correct pre-operative diagnosis was made in only 13 cases (59%). In the remaining cases, four were identified intraoperatively following negative exploration for a supposed inguinal hernia. The other five were found to have a femoral hernia 1 month to 12 months after ipsilateral inguinal hernia repair. All patients underwent elective surgery. The femoral canal was closed using either Lytle or McVay procedure. Recurrence occurred in only one patient 2 months after initial repair. Femoral hernias are often misdiagnosed. Pre-operative diagnosis can be obtained through careful clinical assessment. In equivocal cases, ultrasonography and laparoscopy could be useful. A correct pre-operative diagnosis will lead to suitable treatment, thus avoiding unnecessary reoperations and their related complications.
Sections du résumé
BACKGROUND
BACKGROUND
Femoral hernias are an uncommon groin pathology among pediatric patients. Therefore, they are frequently misdiagnosed. In the present study, we review our experience with this rare surgical entity during the past 25 years.
METHODS
METHODS
The medical records of 19 patients who underwent 22 femoral hernia repairs between January 1994 and December 2019 were retrospectively analysed.
RESULTS
RESULTS
Patients' age ranged from 2 to 12 years (mean age was 5. 5 years) with an approximately equal sex ratio (10 girls/9 boys). There were three bilateral cases identified separately. They were discovered and managed at different times. All the children were referred with a groin lump, but the correct pre-operative diagnosis was made in only 13 cases (59%). In the remaining cases, four were identified intraoperatively following negative exploration for a supposed inguinal hernia. The other five were found to have a femoral hernia 1 month to 12 months after ipsilateral inguinal hernia repair. All patients underwent elective surgery. The femoral canal was closed using either Lytle or McVay procedure. Recurrence occurred in only one patient 2 months after initial repair.
CONCLUSION
CONCLUSIONS
Femoral hernias are often misdiagnosed. Pre-operative diagnosis can be obtained through careful clinical assessment. In equivocal cases, ultrasonography and laparoscopy could be useful. A correct pre-operative diagnosis will lead to suitable treatment, thus avoiding unnecessary reoperations and their related complications.
Identifiants
pubmed: 34341202
pii: AfrJPaediatrSurg_2021_18_3_164_322002
doi: 10.4103/ajps.AJPS_74_20
pmc: PMC8362919
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
164-167Déclaration de conflit d'intérêts
None
Références
Int J Surg. 2011;9(6):472-4
pubmed: 21640856
AJR Am J Roentgenol. 2006 Nov;187(5):1168-78
pubmed: 17056901
Nagoya J Med Sci. 2015 Aug;77(3):531-5
pubmed: 26412902
J Laparoendosc Adv Surg Tech A. 2009 Oct;19(5):691-4
pubmed: 19694567
Surg Endosc. 2010 Feb;24(2):395-9
pubmed: 19551430
Br Med J. 1964 Oct 24;2(5416):1052-3
pubmed: 14191169
J Pediatr Surg. 2006 Jun;41(6):1081-4
pubmed: 16769338
Ann Surg. 1958 Nov;148(5):823-6
pubmed: 13595543
Hernia. 2012 Aug;16(4):381-5
pubmed: 22638924
Ann Surg. 1961 Dec;154(Suppl 6):25-32
pubmed: 17859685
Br J Clin Pract. 1990 Sep;44(9):383
pubmed: 2223537
Ann Surg. 1967 Aug;166(2):287-9
pubmed: 6029579
Hernia. 2017 Jun;21(3):443-447
pubmed: 28197793
Ann Surg. 1966 Feb;163(2):227-32
pubmed: 5906611
Pediatr Surg Int. 2003 Oct;19(8):608-9
pubmed: 12955419
Surg Endosc. 2000 Dec;14(12):1110-3
pubmed: 11148777
Arch Surg. 1984 Oct;119(10):1161-4
pubmed: 6477102
J Pediatr Surg. 1998 Dec;33(12):1784-7
pubmed: 9869050
J Pediatr Surg. 1972 Feb;7(1):40-3
pubmed: 5013123
Hernia. 2008 Oct;12(5):553-6
pubmed: 18330665
J Pediatr Surg. 1999 Jul;34(7):1104-6
pubmed: 10442600
Arch Surg. 1987 Aug;122(8):950-1
pubmed: 3632343
Mil Med. 1991 Nov;156(11):631-3
pubmed: 1771014
Am J Surg. 1960 Jun;99:904-5
pubmed: 13797703
Br J Surg. 1997 Jan;84(1):58-60
pubmed: 9043453
J Pediatr Surg. 1966 Aug;1(4):338-41
pubmed: 4862786
Ann Surg. 1918 Sep;68(3):255-68
pubmed: 17863979
Pediatr Surg Int. 1997 Sep;12(7):520-1
pubmed: 9238121