The diagnosis and classification of inguinal and femoral hernia on multisection spiral CT

Cherian, P. Thomas; Parnell, A.

doi:10.1016/j.crad.2007.07.018

Cited by 37 publications

(12 citation statements)

References 11 publications

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“…Should there be a need to distinguish the type of hernia, ultrasound is shown to be accurate in diagnosing and differentiating direct and indirect hernias, although it may be operator dependent (Lilly and Arregui, 2002). Modern multisection spiral CT can be used to distinguish direct, indirect, and femoral hernias through high-resolution coronal and sagittal reconstructions, which accurately demonstrate the anatomy (Cherian and Parnell, 2008).…”

Section: Discussionmentioning

confidence: 98%

Anatomical differentiation of direct and indirect inguinal hernias: Is it worthwhile in the modern era?

et al. 2010

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The study aimed to assess the clinical accuracy of differentiating direct and indirect inguinal hernias preoperatively by different grades of surgeons. A retrospective audit was conducted over a 9-year period and comprised all adult inguinal hernia patients operated by one consultant surgeon. The hernias were differentiated into direct and indirect hernias based on the direction of cough impulse and the deep ring occlusion test. The preoperative diagnosis was compared with intraoperative findings. During the study period, 503 patients were examined. Of these, 272 patients were diagnosed as having indirect hernias and 56 patients as having direct hernias. In 175 patients, no attempt was made to differentiate indirect and direct hernias. When compared with intraoperative findings, the diagnosis was correct in 77% of the indirect hernias and 55% of direct hernias. Of the patients in whom no differentiation was attempted, 115 patients had indirect hernias, 56 had direct hernias, and four had both. For indirect hernias, the diagnostic accuracy was 82, 63, and 30% for consultant, registrars, and senior house officers. For direct hernias, the diagnostic accuracy was 66, 50, and 44%, respectively. This study demonstrates relatively poor accuracy in diagnosing direct inguinal hernias regardless of seniority.

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Section: Discussionmentioning

confidence: 98%

Anatomical differentiation of direct and indirect inguinal hernias: Is it worthwhile in the modern era?

et al. 2010

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“…Therefore, accurate imaging is vital to ensure diagnosis of inguinal hernia in patients with such presentations (10,11). Scanner technology with multi-planar reformatting makes it possible to produce high resolution sagittal, coronal and oblique images in any plane from raw axial images that allows visualization of relevant anatomic structures (4,8,12,13). It is reported that the inferior epigastric artery has been visible in 90% of the cases, especially on unenhanced computed tomography examinations (1).…”

Section: Discussionmentioning

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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“…Another useful imaging feature for differentiating femoral and inguinal hernias is the posterolateral location of the hernia sac to the pubic tubercle (38,40,41), with concurrent mass effect on the femoral vein (Fig 18). These two findings were present in 98% of femoral hernias and only 1% of inguinal hernias.…”

Section: Indirect Inguinal Hernias-indirect Inguinalmentioning

confidence: 99%

From Inguinal Hernias to Spermatic Cord Lipomas: Pearls, Pitfalls, and Mimics of Abdominal and Pelvic Hernias

et al. 2017

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Abdominal and pelvic hernias may be indolent and detected incidentally, manifest acutely with pain and distress, or cause chronic discomfort. Physical examination findings are often ambiguous and insufficient for optimal triage. Therefore, accurate anatomic delineation and identification of complications are critical for effective treatment planning. Imaging, particularly computed tomography, provides a vital understanding of the hernia's location and size, involved viscera, and severity of associated complications. Reader familiarity with the imaging appearances and anatomic landmarks of hernias is important for correct diagnosis, which may impact preoperative planning and reduce morbidity. This article reviews the appearance of anatomic structures in the abdominal wall and pelvis that are important for diagnosing common and uncommon abdominal and pelvic hernias, and it highlights key imaging features that are helpful for differentiating hernias, mimics, and their complications. Online DICOM image stacks are available for this article . RSNA, 2017.

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The diagnosis and classification of inguinal and femoral hernia on multisection spiral CT

Cited by 37 publications

References 11 publications

Anatomical differentiation of direct and indirect inguinal hernias: Is it worthwhile in the modern era?

Anatomical differentiation of direct and indirect inguinal hernias: Is it worthwhile in the modern era?

Usefulness of Computed Tomography for Differentiation of Primary Inguinal Hernia

From Inguinal Hernias to Spermatic Cord Lipomas: Pearls, Pitfalls, and Mimics of Abdominal and Pelvic Hernias

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