Volume : 7, Issue : 10, October - 2018

BILATERAL FEMOROCELE : FIRST CASE EVER REPORTED

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

Abstract :

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