Computed Tomographic Appearance of Prolene Hernia System and Polypropylene Mesh Plug Inguinal Hernia Repair

Yeung, Victor Hip Wo; Pearl, Jeffrey M.; Coakley, Fergus V.; Joe, Bonnie N.; Westphalen, Antonio C.; Yeh, Benjamin M.

doi:10.1097/rct.0b013e31815145c8

Cited by 14 publications

(15 citation statements)

References 9 publications

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“…It has been also speculated that the inguinal ligament could not be demonstrated on CT examinations in all cases (8). Therefore, the pubic tubercle has been proposed to be a valuable CT reference point in distinguishing direct inguinal, indirect inguinal and femoral hernias (1,2,8). Besides the study by Delabrousse (1), we could get discordant results by using the pubic tubercle as a reference point in distinguishing the direct and indirect inguinal hernias.…”

Section: Discussionmentioning

confidence: 99%

“…Inguinal hernia is a frequent condition, and inguinal hernia repair is one of the most commonly performed operations in practice of general surgery throughout the world (1)(2)(3). The perception of inguinal anatomy with regard to the pathologic changes occurred during hernia formation may be an important issue for preoperative diagnosis of direct and indirect inguinal hernias (4).…”

Section: Introductionmentioning

confidence: 99%

“…Although clinical diagnosis of these two types of inguinal hernias is possible by physical examination, computed tomography (CT) has dramatically improved preoperative diagnosis (1)(2)(3)(4)(5)(6). Fine detailed anatomy of the inguinal region can also be well visualized with CT to improve the diagnosis and the differentiation between the hernia types (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of Computed Tomography for Differentiation of Primary Inguinal Hernia

Hasbahçeci

Erol

2015

GMJ

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Objective: The perception of inguinal anatomy during hernia formation may be an important issue for the evaluation of hernias. This study was conducted to describe detailed anatomy of inguinal region in patients with primary inguinal hernia by using computed tomography. Methods: Study group included 18 inguinal hernia patients with computed tomography images. Images with multi-planar reformatting were evaluated with regard to anatomical landmarks found in inguinal region. Results: Visualization of inguinal ligament and inferior epigastric artery was possible in all patients. Type of inguinal hernia was defined correctly in all patients by using inferior epigastric artery as an anatomic landmark. Pubic tubercle and lateral crescent sign in differentiation between direct and indirect inguinal hernias had variable sensitivity and specificity (0.69 and 0.60 for pubic tubercle, and 0.69 and 0.80 for lateral crescent sign, respectively). Conclusion: Multi-planar reformatting helps physicians to differentiate types of inguinal hernia by using the inferior epigastric artery as an anatomic landmark.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Usefulness of Computed Tomography for Differentiation of Primary Inguinal Hernia

Hasbahçeci

Erol

2015

GMJ

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“…3d) between the operated side and the contralateral one may be sometimes encountered months to years after uncomplicated IHR: this imaging appearance causes diagnostic uncertainty when the radiologist is unaware of the previous ipsilateral surgery. Furthermore, after laparoscopy subcutaneous and preperitoneal air is commonly observed, and should not be reported as abnormal (6,9,10).…”

Section: Expected Postoperative Imaging Findingsmentioning

confidence: 99%

“…FPLs do not represent complications, and should not be misinterpreted as hematomas, abscesses, pelvic lymphadenopathy, or epiploic appendagitis, to obviate unnecessary treatment. Useful findings for differential diagnosis are listed in Table 1 (9,15).…”

Section: Expected Postoperative Imaging Findingsmentioning

confidence: 99%

Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery

Tonolini

2016

Diagn Interv Radiol

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A rguably the most frequent general surgery procedure, inguinal hernia repair (IHR) reaches an annual rate of approximately 200 operations per 100.000 people/years. Since the introduction of the open-mesh IHR by Lichtenstein in 1989, tension-free hernioplasty with prosthetic mesh (PM) implantation became the standard of care and decreased the likelihood of recurrence by approximately 50%. Furthermore, the increasing use of laparoscopy in IHR allows faster recovery, decreased postoperative pain, lower risk of postoperative seroma, wound infection and hemorrhage, lower incidence of chronic pain and long-term hernia recurrence-at the price of longer operative time and higher risk of rare yet serious visceral injuries (1-5).Since most general hospitals perform hundreds of IHR procedures each year, radiologists are increasingly requested to investigate suspected iatrogenic complications (6, 7).Some authors recommend ultrasonography (US) as a helpful first-line modality to assess the operated groin, which allows rapid and confident detection of anechoic fluid seromas abutting the PM. However, US is often hampered by obesity, thickened subcutaneous fat, medications, and local tenderness at the surgical wound. Furthermore, hypo-anechoic or septated collections corresponding to hematomas or abscesses are sonographically challenging to interpret (7,8).During the last decade, some focused radiologic reports described the expected postsurgical computed tomography (CT) appearances after PM-IHR, particularly the characteristic pseudolesions which are discussed in-depth in a dedicated section of this paper (6, 9). Conversely, very limited literature exists on cross-sectional imaging of iatrogenic complications, mostly including a 2004 review based on axial CT (10) and a recent paper generally devoted to imaging complications related to laparoscopic access (11).This paper provides an overview of contemporary IHR, reviews and illustrates the expected postoperative imaging appearances and iatrogenic injuries with emphasis on multidetector CT findings. Overview of surgical techniquesAs recent studies estimated a very low (<1%) risk of incarceration, a reducible inguinal hernia is not an indication for surgery unless the patient complains of pain or discomfort. E M E R G E N C Y R A D I O LO G Y P I C TO R I A L E S S AY ABSTRACTInguinal hernia repair (IHR) with prosthetic mesh implantation is the most common procedure in general surgery, and may be performed using either an open or laparoscopic approach. This paper provides an overview of contemporary tension-free IHR techniques and materials, and illustrates the expected postoperative imaging findings and iatrogenic injuries. Emphasis is placed on multidetector CT, which represents the ideal modality to comprehensively visualize the operated groin region and deeper intra-abdominal structures. CT consistently depicts seroma, mesh infections, hemorrhages, bowel complications and urinary bladder injuries, and thus generally provides a consistent basis for therapeutic choice. Since ...

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Mimickers of neoplasm on abdominal and pelvic CT

2014

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Computed Tomographic Appearance of Prolene Hernia System and Polypropylene Mesh Plug Inguinal Hernia Repair

Abstract: Focal inguinal findings from mesh plug inguinal hernioplasty are common, have characteristic appearances at CT, and should not be mistaken as lymphadenopathy.

Cited by 14 publications

References 9 publications

Usefulness of Computed Tomography for Differentiation of Primary Inguinal Hernia

Usefulness of Computed Tomography for Differentiation of Primary Inguinal Hernia

Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery

Mimickers of neoplasm on abdominal and pelvic CT

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