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

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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.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan

    Ryoichi Miyamoto, Yuki Inagaki & Naoya Ikeda

  2. Department of Radiology, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan

    Masanari Shiigai

  3. Department of Radiology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Sodai Hoshiai

  4. Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Tatsuya Oda

Authors
  1. Ryoichi Miyamoto
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  2. Masanari Shiigai
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  3. Sodai Hoshiai
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  4. Yuki Inagaki
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  5. Naoya Ikeda
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Correspondence to Ryoichi Miyamoto.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (#2019-041) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Miyamoto, R., Shiigai, M., Hoshiai, S. et al. Atypical femoral hernia called Laugier’s hernia: clinical features, radiological findings, and management at a single center. Langenbecks Arch Surg 405, 445–450 (2020). https://doi.org/10.1007/s00423-020-01897-w

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  • DOI: https://doi.org/10.1007/s00423-020-01897-w

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