Femoral Hernia Diagnosis and Management

Clinical Presentation and Diagnosis

X-ray findings of distended small bowel with multiple air-fluid levels confirm mechanical small bowel obstruction, which is a common presentation in patients with femoral hernias 1, 2
The tympanic abdomen suggests significant gaseous distension from the obstruction, indicating a high risk of strangulation in femoral hernias 3, 4
Metastatic lymph node would not cause mechanical small bowel obstruction with the classic radiographic findings described, making femoral hernia a more likely diagnosis 2

The combination of non-reducible hernia, vomiting, and small bowel obstruction indicates strangulation until proven otherwise, requiring urgent surgical intervention 1, 2
Delayed surgical intervention beyond 72 hours significantly increases morbidity and mortality, emphasizing the need for prompt treatment 2