Femoral hernia in children

Background/Purpose: Femoral herniae are uncommon in children and easily misdiagnosed. To evaluate performance with femoral hernia in children, the authors reviewed their experience for the past two decades. Methods: All patients under 15 years of age with femoral hernia (January 1977 to January 1998) were reviewed. Age, gender, presentation, surgical findings and procedure, and previous repair were recorded. Results: There were nine girls (53%) and eight boys (47%). Age range was 2 to 15 years. Thirteen were right side (77%), three were left side (18%), and one was bilateral (6%). All presented with a recurrent lump in the groin, one with incarceration. Duration of symptoms ranged from 1 day to 3 years (median, 3 months). Six cases were diagnosed correctly preoperatively (35%); the others were thought to be either an inguinal hernia or recurrent inguinal hernia. Conclusions: Femoral hernia in childhood is a challenging clinical problem because of its rarity and similar clinical presentation as indirect inguinal hernia. The frequency with which an incidental indirect inguinal hernia sac or patent processus vaginalis can be found at surgery can perpetuate a misdiagnosis. The absence of an expected indirect inguinal hernia sac or an apparent recurrence of an indirect inguinal hernia should lead to consideration of a possible femoral hernia.