A 70-year-old woman presents with a painful tender swelling in the right groin below and lateral to the pubic tubercle. The swelling is irreducible. Which type of hernia is MOST likely and what is a specific concern about its content?

• A Indirect inguinal hernia — risk of testicular ischaemia
• B Direct inguinal hernia — rarely strangulates due to wide neck
• C Femoral hernia — high risk of strangulation and may contain Richter-type partial bowel wall ✓
• D Obturator hernia — located medial to femoral vessels

Explanation

A femoral hernia passes through the femoral canal, which lies below and lateral to the pubic tubercle (unlike inguinal hernias which are above and medial). Femoral hernias have the highest rate of strangulation among all external hernias due to the rigid, narrow neck formed by the femoral ring. A Richter's hernia — where only part of the bowel wall is trapped — is classically associated with femoral hernias and can strangulate without causing complete intestinal obstruction, making diagnosis more difficult.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.