Femoral hernia physical examination: Difference between revisions

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{{Femoral hernia}}
{{Femoral hernia}}
{{CMG}}
 
{{CMG}}; {{AE}} {{MKA}}
 
==Overview==
==Overview==
Patients with femoral hernia usually appear normal. [[Physical examination]] of patients with femoral hernia is usually remarkable for [[swelling]] or [[lump]] below the [[inguinal ligament]]. It is a difficult [[diagnosis]] and maybe impossible to differentiate from [[inguinal hernia]]. If incarceration is present, the [[swelling]] or [[lump]] maybe [[Tenderness|tender]].
==Physical Examination==
==Physical Examination==
===Signs===
*The presence of [[lump]] or [[swelling]] below the [[inguinal ligament]] on [[physical examination]] is highly suggestive of femoral hernia.<ref name="pmid25693015">{{cite journal| author=Fitzgibbons RJ, Forse RA| title=Clinical practice. Groin hernias in adults. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 8 | pages= 756-63 | pmid=25693015 | doi=10.1056/NEJMcp1404068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25693015  }} </ref><ref name="pmid21250263">{{cite journal |vauthors=Walker HK, Hall WD, Hurst JW, Amerson JR |title= |journal= |volume= |issue= |pages= |year= |pmid=21250263 |doi= |url=}}</ref>
The obvious finding may be a lump in the groin. Cough impulse is often absent and should not be relied on solely when making a diagnosis of femoral hernia. The lump is more globular than the pear shaped lump of the inguinal hernia. The bulk of a femoral hernia lies below an imaginary line drawn between the [[Ilium (bone)|anterior superior iliac spine]] and the [[Ilium (bone)|pubic tubercle]] (which essentially represents the [[inguinal ligament]]) whereas an inguinal hernia starts above this line. Nonetheless, it is often impossible to distinguish the two preoperatively.
 
===Appearance of the patient===
*Patients with femoral hernia usually appear normal.
 
===Vital signs===
*[[Vital signs]] of patients with femoral hernia are usually normal.
*If [[Incarcerated hernia|incarceration]] is present, the following [[vital signs]] maybe present indicating [[sepsis]]:<ref name="pmid25693015">{{cite journal| author=Fitzgibbons RJ, Forse RA| title=Clinical practice. Groin hernias in adults. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 8 | pages= 756-63 | pmid=25693015 | doi=10.1056/NEJMcp1404068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25693015  }} </ref>
**[[Fever]]
**[[Tachycardia]] with regular [[pulse]]
**[[Low blood pressure]]
 
===Skin===
*[[Skin]] examination of patients with femoral hernia is usually normal.
 
===HEENT===
*HEENT examination of patients with femoral hernia is usually normal.
 
===Neck===
*Neck examination of patients with femoral hernia is usually normal.
 
===Lungs===
*[[Pulmonary]] examination of patients with femoral hernia is usually normal.
 
===Heart===
*[[Cardiovascular]] examination of patients with femoral hernia is usually normal.
 
===Abdomen===
*[[Abdominal]] examination of patients with femoral hernia is usually normal.
*If [[Incarcerated hernia|incarceration]] is present [[bowel]] sounds maybe absent.<ref name="pmid25693015">{{cite journal| author=Fitzgibbons RJ, Forse RA| title=Clinical practice. Groin hernias in adults. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 8 | pages= 756-63 | pmid=25693015 | doi=10.1056/NEJMcp1404068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25693015  }} </ref><ref name="pmid25489584">{{cite journal| author=Yang XF, Liu JL| title=Acute incarcerated external abdominal hernia. | journal=Ann Transl Med | year= 2014 | volume= 2 | issue= 11 | pages= 110 | pmid=25489584 | doi=10.3978/j.issn.2305-5839.2014.11.05 | pmc=4245506 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25489584  }} </ref>
 
===Back===
*Back examination of patients with femoral hernia is usually normal.
 
===Genitourinary===
*[[Swelling]] or [[lump]] may be present below the [[inguinal ligament]].<ref name="pmid25693015">{{cite journal| author=Fitzgibbons RJ, Forse RA| title=Clinical practice. Groin hernias in adults. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 8 | pages= 756-63 | pmid=25693015 | doi=10.1056/NEJMcp1404068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25693015  }} </ref><ref name="pmid21250263">{{cite journal |vauthors=Walker HK, Hall WD, Hurst JW, Amerson JR |title= |journal= |volume= |issue= |pages= |year= |pmid=21250263 |doi= |url=}}</ref>
*If [[Incarcerated hernia|incarceration]] is present the palpable [[swelling]] below the [[inguinal ligament]] may be [[Tenderness|tender]].<ref name="pmid25693015">{{cite journal| author=Fitzgibbons RJ, Forse RA| title=Clinical practice. Groin hernias in adults. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 8 | pages= 756-63 | pmid=25693015 | doi=10.1056/NEJMcp1404068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25693015  }} </ref><ref name="pmid25489584">{{cite journal| author=Yang XF, Liu JL| title=Acute incarcerated external abdominal hernia. | journal=Ann Transl Med | year= 2014 | volume= 2 | issue= 11 | pages= 110 | pmid=25489584 | doi=10.3978/j.issn.2305-5839.2014.11.05 | pmc=4245506 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25489584  }} </ref>
 
===Neuromuscular===
* [[Neuromuscular]] examination of patients with femoral hernia is usually normal.
 
===Extremities===
* Examination of extremities of patients with femoral hernia is usually normal.
 
==References==
==References==
{{reflist|2}}
{{Reflist|2}}
[[Category:Needs content]]
 
[[Category:Surgery]]
[[Category:Gastroenterology]]
[[Category:Up-To-Date]]
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[[Category:Emergency medicine]]
 
 
 
{{WH}}
{{WS}}
[[Category: (name of the system)]]

Latest revision as of 16:31, 15 February 2018

Femoral hernia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]

Overview

Patients with femoral hernia usually appear normal. Physical examination of patients with femoral hernia is usually remarkable for swelling or lump below the inguinal ligament. It is a difficult diagnosis and maybe impossible to differentiate from inguinal hernia. If incarceration is present, the swelling or lump maybe tender.

Physical Examination

Appearance of the patient

  • Patients with femoral hernia usually appear normal.

Vital signs

Skin

  • Skin examination of patients with femoral hernia is usually normal.

HEENT

  • HEENT examination of patients with femoral hernia is usually normal.

Neck

  • Neck examination of patients with femoral hernia is usually normal.

Lungs

  • Pulmonary examination of patients with femoral hernia is usually normal.

Heart

  • Cardiovascular examination of patients with femoral hernia is usually normal.

Abdomen

Back

  • Back examination of patients with femoral hernia is usually normal.

Genitourinary

Neuromuscular

  • Neuromuscular examination of patients with femoral hernia is usually normal.

Extremities

  • Examination of extremities of patients with femoral hernia is usually normal.

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Fitzgibbons RJ, Forse RA (2015). "Clinical practice. Groin hernias in adults". N Engl J Med. 372 (8): 756–63. doi:10.1056/NEJMcp1404068. PMID 25693015.
  2. ↑ 2.0 2.1 Walker HK, Hall WD, Hurst JW, Amerson JR. PMID 21250263. Missing or empty |title= (help)
  3. ↑ 3.0 3.1 Yang XF, Liu JL (2014). "Acute incarcerated external abdominal hernia". Ann Transl Med. 2 (11): 110. doi:10.3978/j.issn.2305-5839.2014.11.05. PMC 4245506. PMID 25489584.

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