BILATERAL FEMOROCELE : FIRST CASE EVER REPORTED

Dr. Kalpit Goriwal, Dr. Adheesh Goriwal, Dr. Sunil Kaul

Abstract


INTRODUCTION :
Hydrocele of femoral hernial sac is an extremely rare entity. Total six authentic cases have been recorded till date.
Bailey [1] reported the 􀃶rst case in 1927; Rives [2] in 1934 had reported two cases of true femoral hydrocele. The femoral canal is located
below the inguinal ligament, lateral to the pubic tubercle; bounded by the inguinal
ligament anteriorly, pectineal ligament posteriorly, lacunar ligament medially, and the femoral vein laterally. It normally contains a few
lymphatics, loose areolar tissue and occasionally a lymph node called Cloquet’s node. Femoral hernia develop as herniations of the
peritoneal sac through the femoral ring into the femoral canal, medial to femoral vessels. The femoral hernia sac have been reported
commonly consisting of omentum or small bowel. Fluid collection in femoral hernia sac from peritoneal cavity gravitated to pouch and
omental plug at narrow neck. Fluid amber color and sterile in nature, with presence of albumin and 􀃶brinogen. In old age, the femoral
defect increases and femoral hernia is commonly seen in low-weight, elderly females seen in women at 4th to 6th decade. Clinical
presentation—painless groin swelling. This never has been diagnosed preoperatively in all cases reported in literature but always only after
surgical exploration, as in our case too. The differential diagnosis in consideration is only as irreducible or incarcerated femoral hernia or cyst
of the canal of Nuck, subcutaneous lipoma or Bartholin’s cyst of labium majora, lymphadenopatheic abscess, or arterial and venous
aneurysms.
Hydrocele of femoral hernia sac: two varieties, i.e.,
i. Primary or true hydrocele of femoral hernia sac: 􀃸uid trapped in the sac of femoral hernia either due to adhesions or omental plugging at
narrow neck of sac, with no evidence of ascites.
ii. Secondary: 􀃸uid collection in sac of femoral hernia from the peritoneal cavity.
The use of mesh is still debatable. Primary tissue repair has been recommended by most studies, particularly if no tension or risk of wound
infection.


Keywords


Femorocele, Hydrocele Of Femoral Hernial Sac, Femoral Hernia

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References


Bailey H (1927) Hydrocele of a femoral hernia sac. Br J Surg 15:166

Rives JD. Femoral hydrocele. Ann Surg. 1934;99:989–992

Madhivanan, S., & Jain, R. K. (2016, June). Hydrocele of Femoral Hernial Sac-an Extremely Rare Case.

McCorkle, H. J., & Bell, H. G. (1941, February). HYDROCELE OF THE FEMORAL HERNIAL SAC.

Mote, D. G., &Chakravarty, K. B. (2009, December). Hydrocoele of a femoral hernia sac.

Thomas, T. M. (1932, July). Case of Hydrocele of Femoral Hernial Sac.


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