Skip to main content
Top
Published in: Langenbeck's Archives of Surgery 4/2020

01-06-2020 | Ileus | Original Article

Atypical femoral hernia called Laugier’s hernia: clinical features, radiological findings, and management at a single center

Authors: Ryoichi Miyamoto, Masanari Shiigai, Sodai Hoshiai, Yuki Inagaki, Naoya Ikeda, Tatsuya Oda

Published in: Langenbeck's Archives of Surgery | Issue 4/2020

Login to get access

Abstract

Purpose

Laugier’s hernia is a rare clinical entity compared with a typical femoral hernia. Therefore, the clinical features, radiological findings, and appropriate treatment strategies remain largely unclear. In this study, we present 15 Laugier’s hernia cases. Additionally, we review the relevant literature and discuss the clinical features, radiological findings, and appropriate treatment strategies pertaining to Laugier’s hernia compared with a typical femoral hernia.

Methods

Among 1260 hernia patients, we retrospectively enrolled 15 Laugier’s hernia patients (1.19%) and 89 femoral hernia patients (7.06%) who underwent herniorrhaphy and compared the demographic characteristics and radiological findings between the two groups.

Results

Regarding the patient characteristics, a significant difference was observed in the presence of pain (p < 0.001) and ileus symptoms (p = 0.001). Regarding the hernia characteristics, significant differences were observed in the size of the hernial sac (p = 0.001), contents of the hernial sac (p = 0.003), repositioning of the hernial sac (p < 0.001), and repair with polypropylene mesh (p < 0.001). The characteristic multi-detector computed tomography (MDCT) findings enabled the preoperative diagnosis of Laugier’s hernia versus conventional femoral hernia.

Conclusion

Surgeons should be alert to the possibility of atypical femoral hernias while examining femoral hernia or inguinal hernia patients. If Laugier’s hernia is suspected, preoperative MDCT is recommended.
Literature
2.
go back to reference Skandalakis LJ (1996) Modern hernia repair, the embryological and anatomical basis of surgery. Parthenon, New York, pp 147–161, plate 1–60 Skandalakis LJ (1996) Modern hernia repair, the embryological and anatomical basis of surgery. Parthenon, New York, pp 147–161, plate 1–60
4.
go back to reference Noda H, Kohno A, Osawa J, Nomi S, Arii S, Shinoda M, Murakami J (1977) Gimbernant hernia (hernia through the lacunar ligament)—a case report. Nippon Geka Hokan 46:770–772PubMed Noda H, Kohno A, Osawa J, Nomi S, Arii S, Shinoda M, Murakami J (1977) Gimbernant hernia (hernia through the lacunar ligament)—a case report. Nippon Geka Hokan 46:770–772PubMed
8.
go back to reference Ates M, Dirican A, Kose E, Isik B, Yilmaz S (2013) First laparoscopic totally extraperitoneal repair of Laugier’s hernia: a case report. Hernia 17(1):121–123CrossRefPubMed Ates M, Dirican A, Kose E, Isik B, Yilmaz S (2013) First laparoscopic totally extraperitoneal repair of Laugier’s hernia: a case report. Hernia 17(1):121–123CrossRefPubMed
9.
go back to reference Hernia Surge Group (2018) International guidelines for groin hernia management. Hernia 22(1):1–165CrossRef Hernia Surge Group (2018) International guidelines for groin hernia management. Hernia 22(1):1–165CrossRef
10.
go back to reference Harslof S, Krum-Møller P, Sommer T, Zinther N, Wara P, Friis-Andersen H (2018) Effect of fixation devices on postoperative pain after laparoscopic ventral hernia repair: a randomized clinical trial of permanent tacks, absorbable tacks, and synthetic glue. Langenbeck's Arch Surg 403(4):529–537CrossRef Harslof S, Krum-Møller P, Sommer T, Zinther N, Wara P, Friis-Andersen H (2018) Effect of fixation devices on postoperative pain after laparoscopic ventral hernia repair: a randomized clinical trial of permanent tacks, absorbable tacks, and synthetic glue. Langenbeck's Arch Surg 403(4):529–537CrossRef
11.
go back to reference Bakker JJ, Öberg S, Andresen K, Helgstrand F, Rosenberg J (2018) Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study. Langenbeck's Arch Surg 403(4):521–527CrossRef Bakker JJ, Öberg S, Andresen K, Helgstrand F, Rosenberg J (2018) Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study. Langenbeck's Arch Surg 403(4):521–527CrossRef
12.
go back to reference Goethals A, Adams CT (2019) Femoral hernia. Source Stat Pearls, Fürstentum Liechtenstein Goethals A, Adams CT (2019) Femoral hernia. Source Stat Pearls, Fürstentum Liechtenstein
13.
go back to reference Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U (2009) Emergency femoral hernia repair: a study based on a national register. Ann Surg 249(4):672–676CrossRefPubMed Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U (2009) Emergency femoral hernia repair: a study based on a national register. Ann Surg 249(4):672–676CrossRefPubMed
14.
go back to reference Anson BJ, Margon EH, Mc Vay CB (1960) Surgical anatomy of the inguinal region based upon a study of 500 body halves. Surg Gynaecol Obstet III:707 Anson BJ, Margon EH, Mc Vay CB (1960) Surgical anatomy of the inguinal region based upon a study of 500 body halves. Surg Gynaecol Obstet III:707
15.
go back to reference Fagan SP, Awad SS (2004) Abdominal wall anatomy: the key to a successful inguinal hernia repair. Am J Surg 188(6A Suppl):3S–8SCrossRefPubMed Fagan SP, Awad SS (2004) Abdominal wall anatomy: the key to a successful inguinal hernia repair. Am J Surg 188(6A Suppl):3S–8SCrossRefPubMed
16.
17.
go back to reference Skandalakis JE, Colborn GL, Skandalakis LJ (1997) The embryology of the inguinofemoral area: an overview. Hernia 1:45–54CrossRef Skandalakis JE, Colborn GL, Skandalakis LJ (1997) The embryology of the inguinofemoral area: an overview. Hernia 1:45–54CrossRef
18.
go back to reference Lane DA, Edwards GE (1962) A case of strangulated prevascular femoral hernia. J Irish Med Assoc 50:107–109 Lane DA, Edwards GE (1962) A case of strangulated prevascular femoral hernia. J Irish Med Assoc 50:107–109
Metadata
Title
Atypical femoral hernia called Laugier’s hernia: clinical features, radiological findings, and management at a single center
Authors
Ryoichi Miyamoto
Masanari Shiigai
Sodai Hoshiai
Yuki Inagaki
Naoya Ikeda
Tatsuya Oda
Publication date
01-06-2020
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 4/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-020-01897-w

Other articles of this Issue 4/2020

Langenbeck's Archives of Surgery 4/2020 Go to the issue