Hernia and abdominal wall: approach to strangulated femoral hernia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia and abdominal wall: approach to strangulated femoral hernia

Sample item

An elderly woman has a tender irreducible femoral swelling with vomiting and suspected gangrenous bowel needing resection. Which operative approach gives the best access to the bowel and the neck of the sac?

ALichtenstein anterior inguinal approachBInguinal approach through the canal (Lotheissen)CLow approach below the inguinal ligament (Lockwood)DHigh approach through a vertical incision lateral to rectus (McEvedy)

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. High approach through a vertical incision lateral to rectus (McEvedy)

The low (Lockwood) approach suits uncomplicated reducible or simple femoral hernias, and the inguinal (Lotheissen) approach is an alternative that weakens the canal floor. When bowel resection is likely, the high McEvedy approach gives access to the peritoneal cavity and the hernia from above.

Option by option

A. Lichtenstein anterior inguinal approach
A Lichtenstein approach is an anterior mesh repair of an inguinal hernia and does not address the femoral canal.
B. Inguinal approach through the canal (Lotheissen)
The inguinal approach opens the canal and weakens its floor, with limited access to resect bowel.
C. Low approach below the inguinal ligament (Lockwood)
The low approach gives limited access and makes resection of strangulated bowel difficult.
D. High approach through a vertical incision lateral to rectus (McEvedy) (correct)
Correct. The high approach allows control of the neck from above and bowel resection if required.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, High approach through a vertical incision lateral to rectus (McEvedy). The low (Lockwood) approach suits uncomplicated reducible or simple femoral hernias, and the inguinal (Lotheissen) approach is an alternative that weakens the canal floor.

Why is "Lichtenstein anterior inguinal approach" not the answer?

A Lichtenstein approach is an anterior mesh repair of an inguinal hernia and does not address the femoral canal.

Why is "Inguinal approach through the canal (Lotheissen)" not the answer?

The inguinal approach opens the canal and weakens its floor, with limited access to resect bowel.

Why is "Low approach below the inguinal ligament (Lockwood)" not the answer?

The low approach gives limited access and makes resection of strangulated bowel difficult.

What concept does this question test?

It tests Hernia and abdominal wall: approach to strangulated femoral hernia in General Surgery. When bowel resection is likely, the high McEvedy approach gives access to the peritoneal cavity and the hernia from above.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia and abdominal wall: approach to strangulated femoral hernia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.