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June 3, 1933

THE INCIDENCE OF FEMORAL HERNIA FOLLOWING REPAIR OF INGUINAL HERNIA—ECTOPIC RECURRENCEA PROPOSED OPERATION OF EXTERNAL AND INTERNAL HERNIORRHAPHY

JAMA. 1933;100(22):1741-1744. doi:10.1001/jama.1933.02740220007002
Abstract

Various forms of hernia are liable to develop after any intra-abdominal operation. Direct hernia has occurred following operation for oblique inguinal hernia and occasionally, though rarely, after an inguinal operation for femoral hernia. In such cases there probably existed a small congenital diverticulum of the peritoneum, which was overlooked at the time of operation. The increase in intra-abdominal pressure due to reduction of the inguinal hernia, together with the stretching and weakening of Hesselbach's triangle caused by the deep sutures, may be sufficient to bring on a direct hernia.

Femoral hernia, likewise, occasionally appears after operation for inguinal hernia. In this case, the increased size of the femoral opening due to the pulling upward of Poupart's ligament in the course of repair of the inguinal hernia may be an etiologic factor.

During the past seven years I have observed four cases of femoral hernia following repair of inguinal hernia by

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