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Allen KamravaMD · MBA · FACS · FASCRS

Colon and Rectum

Femoral Hernia

A femoral hernia is a bulge in the upper thigh near the groin, caused by abdominal contents pushing through a weak spot in the abdominal wall called the femoral canal.

Reviewed by Allen Kamrava, MD, MBA, FACS, FASCRS · Last reviewed 2025-10-12

Overview

What is a femoral hernia?

A femoral hernia is a type of groin hernia that occurs when a portion of the intestine or abdominal fat pushes through a weak spot in the abdominal wall into the femoral canal. The femoral canal is a small passageway in the upper thigh, just below the inguinal ligament, that contains the femoral artery, vein, and nerve. Femoral hernias appear as a bulge in the upper thigh, just below the groin crease. They are much less common than inguinal hernias, accounting for only about 3% of all hernias. They occur much more frequently in women than in men, often due to the wider shape of the female pelvis.

Symptoms

What are the symptoms of a femoral hernia?

Many small femoral hernias do not cause any symptoms. When they get larger, you may notice a bulge in your upper thigh near your groin. The bulge may be more apparent when you stand, lift something heavy, or cough. You might also experience:

  • Mild discomfort or aching in the groin or upper thigh.
  • The pain may worsen with standing, lifting, or straining.

Causes & risk factors

What causes a femoral hernia?

A femoral hernia is caused by a weakness in the abdominal wall that allows the femoral canal to widen. Anything that increases pressure inside the abdomen can then force tissue through this opening. Risk factors include:

  • Childbirth: Multiple pregnancies can weaken the pelvic floor and abdominal muscles.
  • Chronic straining: From constipation, chronic coughing, or difficulty urinating.
  • Heavy lifting.
  • Obesity.
  • Aging: Muscle weakness increases with age.

When to see a doctor

When should I see a doctor?

You should see a doctor as soon as you notice a bulge or have persistent pain in your groin or upper thigh. Femoral hernias have a very high risk of becoming incarcerated and strangulated. Because the femoral canal is narrow and rigid, the contents of the hernia can easily become trapped. For this reason, surgical repair is almost always recommended as soon as a femoral hernia is diagnosed.

Urgent — get care now

When is it an emergency?

A femoral hernia is a surgical emergency if it becomes incarcerated (trapped) or strangulated. This is a very common complication of femoral hernias. Strangulation occurs when the blood supply to the trapped tissue is cut off, which can lead to tissue death (gangrene) and a life-threatening infection.

You must seek immediate medical attention if you have a bulge in your groin and develop:

  • Sudden, severe groin or abdominal pain.
  • Nausea and vomiting.
  • The bulge becomes firm, tender, and cannot be pushed back in.
  • The bulge changes color to red or purple.

Diagnosis & tests

How is a femoral hernia diagnosed?

A femoral hernia is usually diagnosed with a physical exam. The doctor will examine your groin and upper thigh area for a bulge. You may be asked to cough or strain to help identify the hernia. Because femoral hernias can be small and are located near the inguinal canal, they can sometimes be difficult to distinguish from an inguinal hernia. If the diagnosis is uncertain, an ultrasound or CT scan of the groin can be used to confirm the presence of a femoral hernia and to see what it contains.

Treatment

How is a femoral hernia treated?

Due to the high risk of strangulation, all femoral hernias should be surgically repaired. The surgery is similar to that for an inguinal hernia and aims to push the protruding tissue back into the abdomen and repair the weak spot in the abdominal wall, usually with a piece of synthetic mesh.

  • Open Repair: A single incision is made in the groin to access the hernia. The defect is repaired and reinforced with mesh. This can be done under local, spinal, or general anesthesia.
  • Laparoscopic Repair: A minimally invasive approach is used, with several small incisions in the abdomen. A laparoscope is used to visualize the hernia from the inside, and a piece of mesh is placed to cover the defect. This is always done under general anesthesia.

If the hernia is strangulated, emergency surgery is required. This often involves removing the portion of the intestine that has lost its blood supply.

Self-care

Recovery after Surgery

Recovery is similar to that for an inguinal hernia repair. You will be advised to avoid heavy lifting and strenuous activity for several weeks. Maintaining a healthy weight and a high-fiber diet to prevent constipation can help reduce the risk of the hernia recurring.

Frequently asked questions

Is a femoral hernia more serious than an inguinal hernia?
Yes, femoral hernias are considered more dangerous than inguinal hernias because they have a much higher risk of strangulation. The femoral ring is a narrow and rigid opening, making it easy for a piece of bowel to become trapped. This is why immediate surgical repair is recommended for all femoral hernias.

Can femoral hernias be prevented?
You cannot prevent the congenital weakness that may lead to a hernia, but you can reduce the strain on your abdominal muscles. Maintaining a healthy weight, eating a high-fiber diet to avoid constipation, and using proper lifting techniques can help lower your risk.

References

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