Childhood femoral hernia:: a commonly misdiagnosed condition

Femoral hernia is a rare surgical entity in the paediatric age group. The diagnosis is still a challenging issue. The aim of our study was to review our experience with femoral hernias in children during the past 21 years. We reviewed retrospectively the medical records of all patients who underwent femoral hernia repair in our institution between 1980 and 2000. Thirty-eight children (20 females, 18 males) with the median age of 5.5 years underwent 42 femoral hernia repairs over a 21-year period. Correct preoperative diagnosis was obtained in 20 (53%) cases. Of the 18 (47%) misdiagnosed cases, 11 were found to have a femoral hernia at negative exploration for a clinically diagnosis of inguinal hernia and 7 were found to have a femoral hernia 1 week to 18 months (mean 2.5 months) post repair of a presumed inguinal hernia. Median follow-up time was 12 years (range, 6 months-22 years). Recurrent femoral hernias occurred in five (13%) patients 6 months to 3 years (mean 13.5 months) after initial hernia repair. This study shows that femoral hernia is still a commonly misdiagnosed condition. A correct preoperative diagnosis will lead to appropriate surgical management, thus avoiding unnecessary morbidity and preventing unnecessary reoperations.