A 70-year-old woman presents with a small, tender swelling below and lateral to the pubic tubercle. It is irreducible. Which statement is MOST accurate regarding this hernia?

• A This is most likely an inguinal hernia; the deep ring lies above and medial to the femoral artery
• B This is most likely an obturator hernia given the age and gender
• C This is most likely a spigelian hernia located at the linea semilunaris
• D This is most likely a femoral hernia; it passes through the femoral canal medial to the femoral vein ✓

Explanation

A swelling below and lateral to the pubic tubercle is consistent with a femoral hernia, which passes through the femoral canal (medial compartment of the femoral sheath, medial to the femoral vein). The narrow femoral ring makes femoral hernias prone to strangulation. They are more common in females (though inguinal hernia remains more common overall even in females). Inguinal hernias emerge above and medial to the pubic tubercle. Femoral hernias are treated operatorily even if asymptomatic due to high strangulation risk.

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.