Value of herniography in the management of occult hernia and chronic groin pain in adults

Calder, F; Evans, R.; Neilson, Donald; Hurley, Paul R.

doi:10.1046/j.1365-2168.2000.01418.x

Cited by 11 publications

(6 citation statements)

References 4 publications

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“…Such cases represent a unique challenge as compared with that of ®nding OCHs, and much has been written on this subject, particularly with respect to the reported usefulness of herniography [2,8,16]. In the current study, as with any, study involving OCH, hernia, patients already had indications for a surgical exploration: the presence of an ipsalateral hernia or a, bilateral hernia.…”

Section: Discussionmentioning

confidence: 83%

Diagnosing the occult contralateral inguinal hernia

Koehler

2001

Surg Endosc

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In this study, patients believed to have unilateral inguinal hernias had OCHs in 13% of cases when examined by TADL. The actual bilateral hernia incidence was 25%, with a 37% false-positive rate for preoperatively diagnosed bilateral hernias. The high rate of bilateral hernias reported by the TEP approach alone suggests that some OCH findings may be an artifact of the TEP dissection. However, failure to search for an OCH could result in up to 13% of patients subsequently requiring a second repair. Because some surgeons are concerned about unnecessary TEP dissection of the asymptomatic contralateral side, the approach described here may offer a solution to accurate diagnosis of the contralateral inguinal region during planned laparoscopic TEP hernia repair.

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Section: Discussionmentioning

confidence: 83%

Diagnosing the occult contralateral inguinal hernia

Koehler

2001

Surg Endosc

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“…By comparison, Ducharme,2 Brierly et al ,3 and Calder et al 4 report a complication rate of 5.8%, 5%, and 3.8% respectively. Some of the problems that have occurred include bradyarrhythmias, peritonitis, intramural small bowel haematoma, injection into the small bowel and bladder, rectus abdominis haematoma, and urinary retention.…”

Section: Discussionmentioning

confidence: 93%

Unexplained groin pain: safety and reliability of herniography for the diagnosis of occult hernias

Gwanmesia

Walsh

Bury³

et al. 2001

Postgraduate Medical Journal

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A retrospective study of our initial experience of herniography in a district general hospital is presented. A total of 43 herniograms were performed in 41 patients (median age 57, range 16-77, 27 males, 14 females) over a two year period. Four herniograms were unsuccessful due to failed intraperitoneal contrast injection, of which two were repeated (success rate 90.5%). A total of 25 groin hernias were identified radiologically (two on the asymptomatic side). Twenty one patients underwent surgery and a hernia was confirmed in 19 (true positive rate 90.5%). Sixteen herniograms were considered negative and after a median follow up of 28 months (range 16-42 months), none of these patients have developed a hernia. There were no major complications. It is concluded that herniography is a safe and reliable method of determining or excluding the presence of an occult groin hernia. (Postgrad Med J 2001;77:250-251)

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“…Herniography is safe, sensitive (100%) and specific (98–100%) in occult hernia [ 55 , 108 , 119 , 123 , 133 , 191 ].…”

Section: Guidelines For the Treatment Of Inguinal Hernia In Adultsmentioning

confidence: 99%

“…The risk of complications is 0–4.3%, and these include contrast allergy, puncture of the intestine, abdominal wall haematoma and short-lasting pain [ 127 , 146 , 212 ]. In cases of obscure pain in the groin with an uncertain diagnosis of inguinal hernia, an initial time of 4 months (in the absence of clinical deterioration) is worthwhile before proceeding to herniography [ 55 ].…”

Section: Guidelines For the Treatment Of Inguinal Hernia In Adultsmentioning

confidence: 99%

European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Simons

Aufenacker

Bay‐Nielsen

et al. 2009

Hernia

1,319

979

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The European Hernia Society (EHS) is proud to present the EHS Guidelines for the Treatment of Inguinal Hernia in Adult Patients. The Guidelines contain recommendations for the treatment of inguinal hernia from diagnosis till aftercare. They have been developed by a Working Group consisting of expert surgeons with representatives of 14 country members of the EHS. They are evidence-based and, when necessary, a consensus was reached among all members. The Guidelines have been reviewed by a Steering Committee. Before finalisation, feedback from different national hernia societies was obtained. The Appraisal of Guidelines for REsearch and Evaluation (AGREE) instrument was used by the Cochrane Association to validate the Guidelines. The Guidelines can be used to adjust local protocols, for training purposes and quality control. They will be revised in 2012 in order to keep them updated. In between revisions, it is the intention of the Working Group to provide every year, during the EHS annual congress, a short update of new high-level evidence (randomised controlled trials [RCTs] and meta-analyses). Developing guidelines leads to questions that remain to be answered by specific research. Therefore, we provide recommendations for further research that can be performed to raise the level of evidence concerning certain aspects of inguinal hernia treatment. In addition, a short summary, specifically for the general practitioner, is given. In order to increase the practical use of the Guidelines by consultants and residents, more details on the most important surgical techniques, local infiltration anaesthesia and a patient information sheet is provided. The most important challenge now will be the implementation of the Guidelines in daily surgical practice. This remains an important task for the EHS. The establishment of an EHS school for teaching inguinal hernia repair surgical techniques, including tips and tricks from experts to overcome the learning curve (especially in endoscopic repair), will be the next step. Working together on this project was a great learning experience, and it was worthwhile and fun. Cultural differences between members were easily overcome by educating each other, respecting different views and always coming back to the principles of evidence-based medicine. The members of the Working Group would like to thank the EHS board for their support and especially Ethicon for sponsoring the many meetings that were needed to finalise such an ambitious project.

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Value of herniography in the management of occult hernia and chronic groin pain in adults

Cited by 11 publications

References 4 publications

Diagnosing the occult contralateral inguinal hernia

Diagnosing the occult contralateral inguinal hernia

Unexplained groin pain: safety and reliability of herniography for the diagnosis of occult hernias

European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

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