The iliopectineal ligament (or iliopubic tract) divides the retro-inguinal space into two compartments. The lateral lacuna musculorum transmits the iliopsoas muscle and femoral nerve; the medial lacuna vasorum transmits the femoral vessels and femoral canal. This division is critical for understanding inguinal hernia anatomy — indirect hernias enter the femoral canal medial to the iliopectineal ligament, while femoral hernias pass through the femoral ring inferior to the inguinal ligament.
| Origin | Inguinal ligament (midpoint) |
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| Insertion | Iliopectineal eminence (pectineal line of the pubis) |
| Actions | Divides the space below the inguinal ligament into the lacuna musculorum (lateral — contains iliacus, psoas, and femoral nerve) and the lacuna vasorum (medial — contains femoral artery, vein, and lymphatics) |
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The femoral ring (femoral hernia entry point) is bounded: anteriorly by the inguinal ligament, medially by the lacunar ligament, laterally by the femoral vein, and posteriorly by the pectineal ligament. Femoral hernias are more common in women (wider pelvis) and have the highest risk of strangulation of any hernia type.
Bowel herniation through the femoral ring medial to the femoral vein managed with urgent mesh repair given the high strangulation risk.
