The role of ultrasound scan in the diagnosis of occult inguinal hernias

Light, Duncan; Ratnasingham, Kumaran; Banerjee, A K; Cadwallader, R.; Uzzaman, Mohammed Mohsin; Gopinath, Bussa

doi:10.1016/j.ijsu.2010.10.014

Cited by 52 publications

(42 citation statements)

References 8 publications

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“…Light et al reported that despite showing a hernia in an ultrasound in 116 examined patients, it was not observed during the surgery in 31 cases. In addition, hernia is sometimes observed during a surgery despite not having been observed during both clinical and ultrasound examinations [14]. Hence, the following question arises: what type of preoperative pain reported by a patient should first and foremost make a physician suspect a hernia with a lack of other obvious symptoms in the inguinal region?…”

Section: Discussionmentioning

confidence: 99%

Factors influencing inguinal hernia symptoms and preoperative evaluation of symptoms by patients: results of a prospective study including 1647 patients

Mitura

Śmietański

Kozieł³

et al. 2018

Hernia

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BackgroundCurrent recommendations for hernia treatment suggest applying techniques aimed at reducing postoperative pain in patients experiencing intense preoperative pain. However, there is still no reliable stratification method of preoperative pain, its circumstances, intensity and frequency, and the current assessments of hernia symptoms are performed by means of a subjective evaluation. The aim of this work is to discuss preoperative pain before hernia repair and determine its nature depending on the type and length of hernia persistence and the patient’s age.Materials and methodsThe data from 1647 patients before inguinal hernia repairs (2010–2017) were registered prospectively in the National Hernia Repair Register (demographic data, pain score and influence on everyday activities).ResultsThe most common symptom upon admission was pain (949 patients at rest; 57.6% and 1561 at physical activity; 94.8%). A significant influence of hernia persistence on the pain occurrence and intensity was not observed between patients with hernia < 12-months (60.8%;VAS5.0) and > 5-years (58.3%;VAS5.4) (p = 0.068). The occurrence and intensity of pain was significantly higher patients < 40-years (63.7%;VAS5.4) than patients > 60-years (54.3%;VAS4.8) (p = 0.008).ConclusionsWhile pain at rest is not a significant problem, undertaking physical activities may intensify pain and increase the number of patients suffering from it. Preoperative assessment of pain may help determine the group of younger patients who could benefit the most from inguinal hernia repair. New indications for prompter admission for treatment should be planned in future studies of patients showing pain at rest for possible prevention of postoperative neuropathy.

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Section: Discussionmentioning

confidence: 99%

Factors influencing inguinal hernia symptoms and preoperative evaluation of symptoms by patients: results of a prospective study including 1647 patients

Mitura

Śmietański

Kozieł³

et al. 2018

Hernia

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“…All the studies included in this review were prospective except 1 retrospective study 12 . That study retrospectively reviewed a patient cohort that had suspected occult groin hernias and had proceeded to sonography and subsequent management, either surgical or conservative.…”

Section: Study Design Characteristicsmentioning

confidence: 99%

“…Three studies looked exclusively at patients with palpable inguinal hernias 13 – 15 . Two studies investigated patients with groin pain but no palpable inguinal hernias 12 , 16 . The remaining 4 studies looked at a combination of these patient groups 17 – 20 .…”

Section: Study Design Characteristicsmentioning

confidence: 99%

Meta-analysis of Sonography in the Diagnosis of Inguinal Hernias

Robinson

Light

Nice

2013

Journal of Ultrasound in Medicine

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Groin hernias are common conditions, and there is a need for accurate imaging when the clinical diagnosis is not clear. A meta-analysis was undertaken to investigate the diagnostic accuracy of sonography in the diagnosis of inguinal hernias. After review of literature searches, 9 original articles were included. Data were pooled and statistically analyzed. In the studies included, sensitivity ranged from 92.7% to 100%; specificity ranged from 22.2% to 100%; the positive predictive value ranged from 83.3 to 100%; and the negative predictive value ranged from 40 to 100%. Sonography has overall sensitivity of 96.6 %, specificity of 84.8%, and a positive predictive value of 92.6%. In cases of diagnostic uncertainty, sonography offers value as an initial imaging modality. It has advantages over other radiologic methods, as it is inexpensive and has minimal complications. When the clinical diagnosis of an inguinal hernia is uncertain, sonographic findings should be interpreted in conjunction with clinical judgment, as its diagnostic accuracy is reduced in the absence of any clinically palpable hernia.

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“…Diagnosis by sonography is reported to obtain sensitivities as high as 94% to 100%. 18,19 The inguinal canal should be imaged with the patient supine, before and while the patient performs the Valsalva maneuver. If no hernia is visualized, images should be taken while the patient is standing.…”

Section: Discussion Herniasmentioning

confidence: 99%

Amyand Hernia Diagnosed With Sonography

Robinson

2011

Journal of Diagnostic Medical Sonography

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Individually, inguinal hernias and acute appendicitis are common, but the combination of the two, acute appendicitis within an inguinal hernia or Amyand hernia (AH), is rare. The overwhelming majority of AH cases are in males and discovered during surgery. To date, only three case reports in the literature of this pathology have been diagnosed with sonography. This is a report of an AH diagnosed in a woman with sonography.

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The role of ultrasound scan in the diagnosis of occult inguinal hernias

Abstract: Ultrasound scan alone in diagnosing groin hernias is not effective when correlated with operative findings. However in conjunction with clinical judgment it is a useful tool in diagnosing occult inguinal groin hernias and aiding in further management.

Cited by 52 publications

References 8 publications

Factors influencing inguinal hernia symptoms and preoperative evaluation of symptoms by patients: results of a prospective study including 1647 patients

Factors influencing inguinal hernia symptoms and preoperative evaluation of symptoms by patients: results of a prospective study including 1647 patients

Meta-analysis of Sonography in the Diagnosis of Inguinal Hernias

Amyand Hernia Diagnosed With Sonography

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