Femoral hernia pathophysiology: Difference between revisions
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**Lacuna musculosa (lateral space), as the name suggests the iliopsoas muscles pass through this space. | **Lacuna musculosa (lateral space), as the name suggests the iliopsoas muscles pass through this space. | ||
**Lacuna vasculosa (medial space), as the name suggests this is the passage for the femoral vessels. | **Lacuna vasculosa (medial space), as the name suggests this is the passage for the femoral vessels. | ||
*In the pelvis along the anterior surface of the iliopsoas muscle run the external iliac vessels.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref> | |||
*The external iliac vessels pass between the iliopubic tract and Cooper's ligament and then under the inguinal ligament to become the femoral vessels.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref> | |||
*As the external iliac vessels pass along the lacuna vasculosa they are covered by the transversalis fascia forming the femoral sheath.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref> | |||
*The femoral sheath extends 4cm caudally to become the adventitia of the femoral vessels.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref> | |||
*The femoral sheath has a medial compartment that is known as the femoral canal.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref> | |||
*The femoral canal is less than 2 cm in diameter and it contains lymphatics and glands.<ref>{{cite book | last = Lichtenstein | first = Irving | title = Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies | publisher = Ishiyaku EuroAmerica | location = St. Louis | year = 1986 | isbn = 0912791306 }}</ref> | |||
===Pathogenesis=== | ===Pathogenesis=== | ||
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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
Pathophysiology
Anatomy
- Pelvicrural interval, an opening from the abdomen to the thigh is divided in to two spaces:[1]
- Lacuna musculosa (lateral space), as the name suggests the iliopsoas muscles pass through this space.
- Lacuna vasculosa (medial space), as the name suggests this is the passage for the femoral vessels.
- In the pelvis along the anterior surface of the iliopsoas muscle run the external iliac vessels.[2]
- The external iliac vessels pass between the iliopubic tract and Cooper's ligament and then under the inguinal ligament to become the femoral vessels.[3]
- As the external iliac vessels pass along the lacuna vasculosa they are covered by the transversalis fascia forming the femoral sheath.[4]
- The femoral sheath extends 4cm caudally to become the adventitia of the femoral vessels.[5]
- The femoral sheath has a medial compartment that is known as the femoral canal.[6]
- The femoral canal is less than 2 cm in diameter and it contains lymphatics and glands.[7]
Pathogenesis
- A femoral hernia is the protrusion of the peritoneal sac through the femoral ring in to the femoral canal posterior and inferior to the inguinal ligament and it is medial to the femoral vessels.[8]
- The hernia sac can contain preperitoneal fat, omentum or small bowel.
- Femoral hernias typically have a narrow neck, which predisposes them to incarceration and the need for emergent surgery.
- De Garengeot hernia is a type of femoral hernia that contains the appendix.[9]
- Littre hernia is an uncommon type of femoral hernia that contain a Meckel's diverticulum.[9]
Genetics
- [Disease name] is transmitted in [mode of genetic transmission] pattern.
- Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
- The development of [disease name] is the result of multiple genetic mutations.
Associated Conditions
Gross Pathology
- On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
Microscopic Pathology
- On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
References
- ↑ Panton JA (1923). "Factors bearing upon the Etiology of Femoral Hernia". J. Anat. 57 (Pt 2): 106–46. PMC 1262989. PMID 17103962.
- ↑ Lichtenstein, Irving (1986). Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies. St. Louis: Ishiyaku EuroAmerica. ISBN 0912791306.
- ↑ Lichtenstein, Irving (1986). Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies. St. Louis: Ishiyaku EuroAmerica. ISBN 0912791306.
- ↑ Lichtenstein, Irving (1986). Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies. St. Louis: Ishiyaku EuroAmerica. ISBN 0912791306.
- ↑ Lichtenstein, Irving (1986). Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies. St. Louis: Ishiyaku EuroAmerica. ISBN 0912791306.
- ↑ Lichtenstein, Irving (1986). Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies. St. Louis: Ishiyaku EuroAmerica. ISBN 0912791306.
- ↑ Lichtenstein, Irving (1986). Hernia repair without disability : a surgical atlas illustrating the anatomy, technique, and physiologic rationale of the "one day" hernia and introducing new concepts : tension-free herniorrhapies. St. Louis: Ishiyaku EuroAmerica. ISBN 0912791306.
- ↑ Doherty, Gerard (2010). Current diagnosis & treatment : surgery. New York: Lange Medical Books/McGraw-Hill. ISBN 978-0071635158.
- ↑ 9.0 9.1 Phillips AW, Aspinall SR (2012). "Appendicitis and Meckel's diverticulum in a femoral hernia: simultaneous De Garengeot and Littre's hernia". Hernia. 16 (6): 727–9. doi:10.1007/s10029-011-0812-2. PMID 21442431.