Bowel obstruction as a serious complication of patients with femoral hernia
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ORIGINAL ARTICLE
Bowel obstruction as a serious complication of patients with femoral hernia Mauricio Gonzalez‑Urquijo1,2 · Valeria C. Tellez‑Giron1 · Emmanuel Martinez‑Ledesma1 · Mario Rodarte‑Shade1,2 · Oscar J. Estrada‑Cortinas1,2 · Gerardo Gil‑Galindo1 Received: 31 May 2020 / Accepted: 25 August 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose The implications of bowel obstruction occurring secondary to femoral hernia have not been discussed in the lit‑ erature recently. Thus, we report our experience of treating patients with femoral hernias complicated by bowel obstruction versus patients with femoral hernias not complicated by bowel obstruction. Methods The subjects of this retrospective study were patients admitted to our hospital for the treatment of femoral hernias between 2016 and 2019. We used the Fisher and Student’s T test to compare the preoperative characteristics, treatment, and outcomes of patients with bowel obstruction versus those without bowel obstruction. Results A total of 53 patients (mean age, 66.9 ± 15.1 years) were treated, 18 (33.9%) of whom underwent elective surgery and 35 (66%) of whom required emergency surgery (p = 0.001). The mean time between the development of symptoms and hospitalization was 4.5 ± 3.1 days for the patients with bowel obstruction and 1.6 ± 3.2 days for those without bowel obstruc‑ tion (p = 0.001). The length of hospital stay was 11.1 ± 21.1 days for the patients with bowel obstruction and 1 ± 1.8 days for those without bowel obstruction (p = 0.028). Overall morbidity and mortality rates were 13.2% and 5.6%, respectively. Conclusion Femoral hernias causing bowel obstruction are associated with greater time between the development of symp‑ toms, hospitalization, and with a longer hospital stay. Keywords Femoral hernia · Bowel obstruction · Bowel resection · Strangulation · Incarceration
Introduction A femoral hernia is a protrusion of the peritoneal sac through the femoral ring into the femoral canal inferior to the ingui‑ nal ligament. The hernia sac can contain preperitoneal fat, abdominal, or pelvic organs [1]. Femoral hernias account for 2–4% of all groin hernias repairs, and are more likely to strangulate than any other abdominal wall hernias, due to the narrow femoral canal; hence, causing bowel obstruc‑ tion, bowel strangulation, and bowel resection, increasing the associated morbidity and mortality to 30% and 10%, * Mauricio Gonzalez‑Urquijo [email protected] 1
Tecnologico de Monterrey, Escuela de Medicina Y Ciencias de La Salud, Dr. Ignacio Morones Prieto O 3000, 64710 Monterrey, Nuevo León, Mexico
Department of Surgery, Hospital Metropolitano “Dr. Bernando Sepúlveda”, Adolfo López Mateos No. 4600, 66400 San Nicolás de los Garza, Nuevo León, Mexico
2
respectively [2, 3]. The diagnosis and treatment of femoral hernia are still a challenge because of the tendency of the sac hernia to move upward above the inguinal ligament, being mistaken for an inguinal hernia [1]. An incarcerated hernia is the second most common ca
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