Ultrasonographic evaluation of bilateral groins in children with unilateral inguinal hernia

Kervancıoğlu, Reşat; Metin, Bayram; Ertaşkın, İdris; Özkur, Ayhan

doi:10.1080/028418500127346081

Cited by 27 publications

(15 citation statements)

References 18 publications

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“…Criterion used for a positive test were the presence of abdominal structures, fluid in the patent processus, and/or a canal width >4mm in three[12–14] studies, the presence of a lumen >2cm from the inferior epigastric vessels in one, [15] and not described in detail in one. [16] The pooled incidence of CPP among these studies was 32% (95% CI 18.7%–45.8%).…”

Section: Resultsmentioning

confidence: 99%

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Evaluation of the contralateral inguinal ring in clinically unilateral inguinal hernia: a systematic review and meta-analysis

Kokorowski

Wang

Routh

et al. 2013

Hernia

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Purpose The management of the contralateral inguinal canal in children with clinical unilateral inguinal hernia is controversial. Our objective was to systematically review the literature regarding management of the contralateral inguinal canal. Methods We searched MEDLINE, EMBASE, and Cochrane databases (1940–2011) using ‘hernia’ and ‘inguinal’ and either ‘pediatric,’ ‘infant,’ or ‘child,’ to identify studies of pediatric (age≤21 yrs) patients with inguinal hernia. Among clinical unilateral hernia patients, we assessed the number of cases with contralateral patent processus (CPP) and incidence of subsequent clinical metachronous contralateral hernia (MCH). We evaluated three strategies for contralateral management: expectant management, laparoscopic evaluation or pre-operative ultrasound. Pooled estimates of MCH or CPP were generated with random effects by study when heterogeneity was found (I2>50%, or Cochrane’s Q p≥0.10). Results We identified 2,477 non-duplicated studies, 129 of which met our inclusion criteria and had sufficient information for quantitative analysis. The pooled incidence of MCH after open unilateral repair was 7.3% (95% CI 6.5%–8.1%). Laparoscopic examination identified CPP in 30% (95% CI 26%–34%). Lower age was associated with higher incidence of CPP (p<0.01). The incidence of MCH after a negative laparoscopic evaluation was 0.9% (95% CI 0.5%–1.3%). Significant heterogeneity was found in studies and pooled estimates should be interpreted with caution. Conclusions The literature suggests that laparoscopically identified CPP is a poor indicator of future contralateral hernia. Almost a third of patients will have a CPP, while less than one in 10 will develop MCH when managed expectantly. Performing contralateral hernia repair in patients with CPP results in overtreatment in roughly 2 out of 3 patients.

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Section: Resultsmentioning

confidence: 99%

“…Among cases suggested by US, CPP was confirmed at exploration in 78% (14/18)[16], 95% (74/78)[15] and 100% (10/10)[12]. The sensitivity of US in symptomatic and asymptomatic hernias from two studies was 98%[14] (323/330) and 97%[13] (458/473).…”

Section: Resultsmentioning

confidence: 99%

Evaluation of the contralateral inguinal ring in clinically unilateral inguinal hernia: a systematic review and meta-analysis

Kokorowski

Wang

Routh

et al. 2013

Hernia

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“…The risk of bias regarding the flow and timing domain was also considered high as most studies limited the use of contralateral exploration as the reference standard to a preset part of their study population [5, 7, 11, 18–20, 22, 23]. Assessment of bias regarding the index test domain and overall applicability concerns were considered low (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In five studies, diagnostic accuracy test results could not be determined because no reference test was performed [5, 11, 22] or the diagnostic or reference test results could not be extracted, calculated or obtained from the authors [7, 23] (Table 3). Two studies were excluded because clinical follow-up was used as reference standard in all children, irrespective of the index test results.…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic accuracy of preoperative ultrasonography in predicting contralateral inguinal hernia in children: a systematic review and meta-analysis

et al. 2018

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• Diagnostic accuracy of preoperative ultrasonography for detection of CPPV in children with unilateral inguinal hernia is high. • Preoperative ultrasonographic evaluation of the contralateral groin assumedly results in an overestimation of MCIH prevalence. • Unequivocal ultrasonographic criteria are mandatory for proper diagnosis of CPPV and risk factor identification is needed to predict whether CPPV develops into clinically apparent MCIH.

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Pelvis and Groin

Robinson

2010

Sports Injuries in Children and Adolescents

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Ultrasonographic evaluation of bilateral groins in children with unilateral inguinal hernia

Abstract: US can be used routinely in the pre-operative diagnosis of inguinal hernia in children. PPV values higher than 4 mm, with a high accuracy indicate hernia.

Cited by 27 publications

References 18 publications

Evaluation of the contralateral inguinal ring in clinically unilateral inguinal hernia: a systematic review and meta-analysis

Evaluation of the contralateral inguinal ring in clinically unilateral inguinal hernia: a systematic review and meta-analysis

Diagnostic accuracy of preoperative ultrasonography in predicting contralateral inguinal hernia in children: a systematic review and meta-analysis

Pelvis and Groin

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