FEMORAL HERNIA: A LIMITED EXPERIENCE WITH A RARE LESION IN PEDIATRIC AGE GROUP

Aim: Femoral hernias are rare in children. The incidence ranged from 0.1% to 1% of all groin hernias in pediatrics. They are often missed clinically. We present our experience and compare it with others. Methods: this is a retrospective study of the cases of femoral hernias managed by the authors over a period of 15 years (January 1995 - December 2009). The files of the patients were reviewed regarding the age at the time of presentation, sex, diagnosis, side, approach of surgical repair as well as follow up. Literature review of the same topic was compared. Results: Seventeen femoral hernias in 12 children (5 males and 7 females) were repaired. Age ranged from 3- 10 years (mean 6.4). There were 4 (33%) right side, 3(25%) left side and 5 (42%) bilateral. Correct preoperative diagnosis was made in 7 patients (58%). Five (42%) patients had incorrectly been diagnosed as inguinal hernia. Thirteen cases (76%) were repaired through the low (infra-inguinal) approach and 4 (24%) via the high (inguinal) one. No case had recurrence over the follow-up period ( 1 - 3 years). Conclusions: Still the incorrect preoperative diagnosis of childhood femoral hernia is high. Remembering it among the differential diagnosis of groin swellings in children, together with the ability to recognize it intraoperatively, could prevent unnecessary second operations