Usefulness of Computed Tomography for Differentiation of Primary Inguinal Hernia

Abstract

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.