Skip to main content
SpringerLink
Log in

Dynamic ultrasound with postural change facilitated the detection of an incisional hernia in a case with negative MRI findings

  • Case Report
  • Published:
Journal of Ultrasound Aims and scope Submit manuscript

Abstract

Incisional hernias commonly develop after abdominal surgeries with a lower incidence in patients receiving laparoscopy. Diagnosis through a non-surgical approach is usually made by computed tomography or magnetic resonance images (MRI) but both image modalities require patients to be examined in a supine position. We reported a case noticing a mass over her right lower abdomen after a laparoscopic liver segmentectomy with negative findings of hernia on MRI. A hernia sac was found by ultrasound with the patient being standing, highlighting the utility of dynamic ultrasound with postural change in investigation of incisional hernias.

Sommario

Il laparocele dopo interventi di chirurgia addominale si realizza con minore incidenza nei pazienti trattati con laparoscopia. La diagnosi non chirurgica di solito è fatta contomografia computerizzata o risonanza magnetica (MRI), ma entrambe le modalità richiedono che i pazienti siano esaminati in posizione supina. Presentiamo un caso di massa del basso addome, a destra, dopo segmentectomia epatica laparoscopica, con risultati negativi per ernia all’esame 24 MRI. L'ecografia, con paziente in piedi, ha evidenziato un sacco erniario, dimostrando l'utilità dell'ecografia dinamica, con cambio posturale, nelle indagini per laparocele.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

References

  1. Le Huu Nho R, Mege D, Ouaissi M, Sielezneff I, Sastre B (2012) Incidence and prevention of ventral incisional hernia. J Visc Surg 149(5 Suppl):e3–e14

    Google Scholar 

  2. Tonouchi H, Ohmori Y, Kobayashi M, Kusunoki M (2004) Trocar site hernia. Arch Surg 139(11):1248–1256

    Article  PubMed  Google Scholar 

  3. Hojer AM, Rygaard H, Jess P (1997) CT in the diagnosis of abdominal wall hernias: a preliminary study. Eur Radiol 7(9):1416–1418

    Article  CAS  PubMed  Google Scholar 

  4. Musella M, Milone F, Chello M, Angelini P, Jovino R (2001) Magnetic resonance imaging and abdominal wall hernias in aortic surgery. J Am Coll Surg 193(4):392–395

    Article  CAS  PubMed  Google Scholar 

  5. Sanz-Lopez R, Martinez-Ramos C, Nunez-Pena JR, Ruiz de Gopegui M, Pastor-Sirera L, Tamames-Escobar S (1999) Incisional hernias after laparoscopic vs open cholecystectomy. Surg Endosc 13(9):922–924

    Article  CAS  PubMed  Google Scholar 

  6. Seiler CM, Diener MK (2010) Which abdominal incisions predispose for incisional hernias? Chirurg 81(3):186–191

    Article  CAS  PubMed  Google Scholar 

  7. Comajuncosas J, Hermoso J, Gris P, Jimeno J, Orbeal R, Vallverdu H, Lopez Negre JL, Urgelles J, Estalella L, Pares D (2013) Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: a prospective 3-year follow-up study. Am J Surg 207(1):1–6

    Article  PubMed  Google Scholar 

  8. Paolucci V, Schaeff B, Schneider M, Gutt C (1999) Tumor seeding following laparoscopy: international survey. World J Surg 23(10):989–995 (discussion 996–987)

    Article  CAS  PubMed  Google Scholar 

  9. Yeh HC, Lehr-Janus C, Cohen BA, Rabinowitz JG (1984) Ultrasonography and CT of abdominal and inguinal hernias. J Clin Ultrasound 12(8):479–486

    Article  CAS  PubMed  Google Scholar 

  10. den Hartog D, Dur AH, Kamphuis AG, Tuinebreijer WE, Kreis RW (2009) Comparison of ultrasonography with computed tomography in the diagnosis of incisional hernias. Hernia 13(1):45–48

    Article  Google Scholar 

  11. Jamadar DA, Jacobson JA, Morag Y, Girish G, Dong Q, Al-Hawary M, Franz MG (2007) Characteristic locations of inguinal region and anterior abdominal wall hernias: sonographic appearances and identification of clinical pitfalls. AJR Am J Roentgenol 188(5):1356–1364

    Article  PubMed  Google Scholar 

  12. Bloemen A, van Dooren P, Huizinga BF, Hoofwijk AG (2011) Comparison of ultrasonography and physical examination in the diagnosis of incisional hernia in a prospective study. Hernia 16(1):53–57

    Article  PubMed  Google Scholar 

  13. Erdas E, Dazzi C, Secchi F, Aresu S, Pitzalis A, Barbarossa M, Garau A, Murgia A, Contu P, Licheri S, Pomata M, Farina G (2012) Incidence and risk factors for trocar site hernia following laparoscopic cholecystectomy: a long-term follow-up study. Hernia 16(4):431–437

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

Patcharaporn Wongsithichai, Ke-Vin Chang, Chen-Yu Hung, and Tyng-Guey Wang declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was not necessary since there is no identifying information in this case report.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Patcharaporn Wongsithichai

  2. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, National Taiwan University College of Medicine, Taipei, Taiwan

    Ke-Vin Chang

  3. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Chu-Tung Branch, Hsinchu, Taiwan

    Chen-Yu Hung

  4. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

    Tyng-Guey Wang

Authors
  1. Patcharaporn Wongsithichai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ke-Vin Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chen-Yu Hung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tyng-Guey Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ke-Vin Chang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wongsithichai, P., Chang, KV., Hung, CY. et al. Dynamic ultrasound with postural change facilitated the detection of an incisional hernia in a case with negative MRI findings. J Ultrasound 18, 279–281 (2015). https://doi.org/10.1007/s40477-014-0146-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40477-014-0146-x

Keywords

Search

Navigation