Femoral hernia in pediatric population: a diagnostic and surgical challenge

Hernia. 2024 Apr;28(2):593-597. doi: 10.1007/s10029-023-02953-2. Epub 2024 Jan 25.

Abstract

Purpose: Femoral hernia (FH) is a rare and often misdiagnosed pathology in pediatric population. The aim of our study was to describe the experience of a Tertiary Center in children with FH, underlying diagnostic and surgical details that could improve its management.

Methods: A retrospective study of pediatric patients who underwent FH repair from January 2010 to June 2023 at our Institution was performed.

Results: In the analyzed period, 31 patients underwent surgical procedure for FH at our institution, of whom 16 (51.6%) were female. The mean age at time of surgery was 5.8 years (range 0.5-17.1 years). The rate of pre-operative misdiagnosis was 35.5% and open approach was adopted in all cases (16.1% with mesh application). Only two patients (6.4%) experienced surgical complications: one recurrence (repaired six months later) and one post-operative hematoma (treated successfully with conservative method).

Conclusion: Due to the high rate of misdiagnosis, the variety of surgical approaches proposed, and the potential for intraoperative complications, FH poses a challenge for pediatric surgeons and urologists, as confirmed by the literature. It is essential to underline the importance of a proper clinical examination in order to correctly diagnose FH, make the best surgical plan for the patient and prevent post-operative complications.

Keywords: Children; Diagnosis; Femoral hernia; Hernia; Recurrence; Surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Hernia, Femoral* / diagnosis
  • Hernia, Femoral* / surgery
  • Hernia, Inguinal* / surgery
  • Herniorrhaphy / adverse effects
  • Herniorrhaphy / methods
  • Humans
  • Infant
  • Laparoscopy* / methods
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh