Swelling below the Groin (Differential Diagnosis as before)

Figure swel_20a_n.jpg and swel_20b_n.jpg: In the pictures a girl is visible from the front and the right side. Below the groin and inguinal ligament, a semispherical smooth (or possibly a tense and painful) swelling can be seen medially on the thigh. The overlying skin is non-irritable (or possibly reddened). Femoral hernia is rarely observed in childhood (0.2% in a large population with pediatric inguinal hernia). It is more frequently observed in girls, bilaterality and/or incarceration may occur. The hernia sack and its intestinal content emerge below the inguinal ligament and medially of the femoral vessels from the peritoneal cavity as shown in the diagrammatic picture on the left side of figure swel_20b_n.jpg. It explains the local findings mentioned above. Surgery includes the ligature of the hernia sack and sutures of the fascia pectinea to the inguinal ligament without restriction of the femoral vein. (Femoral (Crural) Hernia/Dia04 and 07. www-cdu.dc.med.unipi.it).