From the Research
To differentiate between femoral and inguinal hernias on CT, focus on the anatomical location relative to the inguinal ligament, with femoral hernias appearing below and lateral to the pubic tubercle, medial to the femoral vessels, and below the inguinal ligament, as demonstrated in studies such as 1 and 2. When evaluating CT scans, it's essential to consider the anteroposterior relationship to the inguinal ligament, as well as the presence of a narrow neck and protrusion through the femoral canal, which are characteristic of femoral hernias.
- Key landmarks to identify include:
- The inguinal ligament
- The pubic tubercle
- The femoral vessels
- The inferior epigastric vessels
- The relationship between the hernia and these landmarks is crucial in distinguishing between femoral and inguinal hernias. Inguinal hernias, on the other hand, are located above the inguinal ligament and medial to the inferior epigastric vessels, with direct inguinal hernias emerging medial to the inferior epigastric vessels through Hesselbach's triangle, and indirect inguinal hernias following the inguinal canal laterally to the inferior epigastric vessels, as noted in 3. The anatomical distinctions between femoral and inguinal hernias are important because femoral hernias have a higher risk of incarceration and strangulation due to their narrow neck, requiring more urgent intervention, while inguinal hernias are more common but generally less likely to become emergent, as discussed in 4 and 5.