Plug mesh repair of rare prevascular femoral hernia : a case report

Prevascular hernia is a rare variant of femoral hernia with very few reports in the literature and is deï¬ned as a hernia sac that is located anterior to the femoral vessels. It has a reported incidence of around0.77% among groin hernias, and 1-16% of all femoral hernias. Moschcowitz is generally credited with the ï¬rst clinical description of prevascular hernia in 1912, but it is also known as Teale's, Narath's or Velpeau 's hernia. Narath described six prevascular hernias in 65 Austrian patients following reduction of congenital hipdislocation.2Moschcowitz described through his case report that prevascular hernia most likely results from the anterior prolongation of the transversalis fascia and peritoneum, lying right on top of thefemoral vessels.2The femoral sheath is an extension of the transversalis fascia, anteriorly and posteriorly, and prevascular hernias develop at a point of weakness of this fascia.4Predisposing factors include previous inguinal hernia repair, congenital hip dislocation, chronic cough, emphysema, previous groin vascular surgery and increased age.