Assessment of Complicated Anterior Abdominal Wall Hernia by Ultrasonography and Colour Doppler

Abstract

Background: A hernia is defined as a protrusion from a structure through the normally tissues containing it, either a focal or diffuse defects in the tissues with many types including: inguinal, femoral, umbilical and paraumbilical, epigastric and incisional hernias. Objective: This study aimed to evaluate anterior abdominal wall hernia using ultrasound and color Doppler. Patients and methods: An interventions study included (48) patients who were referred from the Surgery Department, Zagazig University Hospitals for sonographic evaluation of the abdominal wall and the abdomen when their clinical presentations were suggestive of abdominal wall hernia obstruction, either progressed or not progressed to bowl obstruction, when their physical examinations were inconclusive or when surgeons believed it was important to determine the contents of a suspected hernia preoperatively. Results: The mean age of the studied patients was 47.5 ± 21.88 years old, with a range from 3 months to 66 years old, less than ½ of the studied patients were males (41.7%) and 58.3 % were females. About 100% of the studied hernias were irreducible containing omentum, while hernias were containing bowel in 95.8% of cases, 41.7 % of cases contained free fluid in hernia sac, 47.8% of the studied patients had absent bowel peristalsis. Comparing the ultrasound finding with the operative data revealed that ultrasound had 100% sensitivity, while accuracy in diagnosis of peristalsis, bowel irreducibility, bowel thickness ranged from 93.4% to 98.8%. Conclusion: High-resolution ultrasonography (US) is an efficient tool for detecting the presence of abdominal wall hernias and accurately detecting the content, and the possible associated complications.