Femorocele: A Rare Form of Femoral Hernia

TL;DR

Femorocele is a rare type of femoral hernia that is often misdiagnosed and can only be confirmed through surgery.

Contribution

The paper highlights the diagnostic challenges and management of femorocele through a case report.

Findings

Femorocele is frequently misdiagnosed preoperatively due to its nonspecific symptoms and rarity.

Surgery is essential for both diagnosis and treatment of femorocele.

Imaging findings must be carefully interpreted to avoid misdiagnosis.

Abstract

Femorocele, also known as a hydrocele of the femoral hernia (FH) sac, is a rare form of FH. Initial misdiagnosis is common not only in FH but is even more frequent in femorocele, due to its rarity and non-distinctive features that make preoperative recognition challenging; in many cases, femorocele is identified only intraoperatively or postoperatively. This report describes a case of femorocele that initially posed a diagnostic challenge and was initially misdiagnosed as a ganglion.

A 63-year-old woman presented with a right sided groin swelling which was suspected as ganglion at the other department. Physical examination was notable for non-reducible and painless mass lateral to pubic tubercle. CT revealed a hydrocele, measuring 57.4 mm in max, medial to common femoral vessels and caudal to inguinal ligament, mostly suspicious of femorocele. Elective surgery via the anterior approach revealed no abnormality in the inguinal canal. A hydrocele originating from the peritoneum and protruding into the femoral canal was observed, consistent with a diagnosis of femorocele. The hernia sac was reduced into the abdominal cavity, and the hernia was repaired using a mesh placed in the preperitoneal space, covering the myopectineal orifice. The patient had an uneventful recovery and was discharged on POD 3.

Femorocele is a rare clinical entity presenting with nonspecific symptoms. Its imaging findings require careful interpretation to avoid misdiagnosis. Surgery remains the only means for establishing a definitive diagnosis and providing curative treatment. Since most cases are identified intraoperatively or postoperatively, or initially misdiagnosed as other conditions, it is essential that all clinicians remain aware of this rare entity.

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