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February 3, 1940

THE DIAGNOSIS AND SURGICAL MANAGEMENT OF STRANGULATED FEMORAL HERNIA

JAMA. 1940;114(5):394-396. doi:10.1001/jama.1940.02810050014003
Abstract

A high mortality attends strangulated femoral hernia. In 1900 Gibson1 found it to be 47 per cent. Thirty years later Counseller and Cox,2 of the Mayo Clinic, stated that there had been only a slight reduction of the death rate despite the advances which had been made in the field of intestinal obstruction. In 1932 McIver3 noted a mortality of 18 per cent when operation was performed early and of 50 per cent when operation was delayed. Homans,4 Christopher5 and Watson6 all emphasize that the mortality is higher in strangulated femoral than in strangulated inguinal hernia. The present communication considers the causes of the high mortality and outlines measures of value in the management of this condition.

Three principal factors contribute to the high mortality of strangulated femoral hernia: delayed treatment, the old age of many of the patients, and improper surgical management. The

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