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Modified Essay Questions, MEQs in General Surgery - Femoral Hernia

FEMORAL HERNIA 

#  A 59-year-old obese woman presented with swelling in the right groin. 
1. List some causes of groin swelling. 
- Inguinal Hernia (direct, indirect)
- femoral hernia, 
- enlarged lymph nodes, 
- psoas abscess, 
- saphena varix, 
- lipoma, 
- enlarged femoral lymph node, 
- psoas abscess, 
- femoral artery aneurysm 


2. On detailed examination and clinical examination, a diagnosis of a femoral hernia was made and operation planned. Enumerate the various operations described for a femoral hernia.
a. Low operation of Lockwood 
b. Inguinal Incision Lotheissen 
c, combined approach- high operation of Mc Evedy 

3. List the various structures encountered during dissection.
- skin, superficial fascia, cribriform fascia, transversalis fascia, fat and lymphoid tissue, sac 

4. Describe the ligaments used for repair of groin hernia.
a. Inguinal ligament - extends from the Anterior superior iliac spine to pubic tubercle
b. Cooper's ligament
c. Conjoint tendon 

After repair, the patient developed features of shock with local hematoma. The wound exploration  was done and a massive retroperitoneal collection with ongoing bleeding in the area of repair was  found. 
6. Mention the likely sources of bleeding. 
- Abnormal obturator artery 
- Femoral artery 
- Femoral vein 

7. Describe other anatomical complications.
-  obstructed hernia, strangulated hernia, Richter's hernia, 

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