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Management of groin hernias detected by ultrasound: a comprehensive study

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Abstract

Introduction

It remains unclear whether ultrasound-detected hernias (UDH) are the sole cause of pain in patients with groin pain, and clinical examination plays a complementary role.

The aim of our study is to describe the evolution of patients with ultrasound detected hernias in terms of development of groin hernia detected by physical examination, pain resolution, and alternative diagnosis.

Methods

An observational, descriptive, longitudinal study of a prospective case series including patients with UDH with groin pain. Follow-up evaluation included the following: follow-up time, side of pain, its evolution, time to resolution, clinical hernia (CH) development, need for surgical resolution, and the presence of postoperative pain and alternative diagnosis.

Results

A total of 98 patients with complete follow-up for groin pain and UDH were included. Seven patients (7.1%) developed CH, with a median time to conversion of 8 months. Four of them (4.1% of the total and 57.1% of the ones who developed CH) ended up having surgery. Fifty-three patients (54.1%) resolved their pain in a median time to resolution of 2 months, and 75.5% of them did so spontaneously. The majority of patients with persistent pain (73.3%) were able to lead a normal life and only reported pain with movement. More than half of the patients (53.3%) reached a specific diagnosis. Among those patients who did not develop CH, 39.6% reached an alternative diagnosis, the majority being musculoskeletal pathologies.

Conclusion

Watchful waiting and a thorough search for other alternative causes of groin pain in UDH and clinically occult hernia would be a reasonable option.

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References

  1. French B, Van Essen C, McDonald C, Ting A (2019) Overuse of Previsit ultrasound in patients referred for treatment of inguinal hernias. Am Surg [Internet] 85(3):261–265. https://www.ncbi.nlm.nih.gov/pubmed/30947771. Accessed Jan 2023

  2. Naidoo P, Levett K, Lord S, Meagher A, Williams N, Aczel T (2021) How often are patients with clinically apparent inguinal hernias referred to a surgeon accompanied with an ultrasound? A prospective multicentre study. Aust Health Rev [Internet] 45(1):36–41. https://doi.org/10.1071/AH20027

  3. Kwee RM, Kwee TC (2018) Ultrasonography in diagnosing clinically occult groin hernia: systematic review and meta-analysis. Eur Radiol [Internet] 28(11):4550–4560. https://doi.org/10.1007/s00330-018-5489-9

  4. Robinson A, Light D, Kasim A, Nice C (2013) A systematic review and meta-analysis of the role of radiology in the diagnosis of occult inguinal hernia. Surg Endosc [Internet] 27:11–88. https://doi.org/10.1007/s00464-012-2412-3

  5. Aly M, Farquharson BM, Clarke O, Atkin GK (2021) Should surgeons repair symptomatic, clinically occult, radiologically evident, inguinal hernias? A case-control study of patient-reported outcomes. Hernia [Internet]. https://doi.org/10.1007/s10029-020-02346-9

  6. Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH et al (2007) The European hernia society groin hernia classification: simple and easy to remember. Hernia [Internet] 11(2):113–116. https://doi.org/10.1007/s10029-007-0198-3

  7. Szopinski J, Dabrowiecki S, Pierscinski S, Jackowski M, Jaworski M, Szuflet Z (2012) Desarda Versus lichtenstein technique for primary inguinal hernia treatment: 3-year results of a randomized clinical trial. World J Surg [Internet] 36:984–992. https://doi.org/10.1007/s00268-012-1508-1

  8. Melloy A, Paine B, Wysocki AP (2019) Pain resolution in non-operatively managed ultrasound-only groin hernias: 3-year follow-up. Hernia [Internet] 23(6):1061–1064. https://doi.org/10.1007/s10029-019-01925-9

  9. van Hout L, Bökkerink WJV, Ibelings MS, Heisterkamp J, Vriens PWHE (2018) Outcomes of surgery on patients with a clinically inapparent inguinal hernia as diagnosed by ultrasonography. Hernia [Internet] 22(3):525–531. https://doi.org/10.1007/s10029-018-1744-x

  10. Jørgensen SG, Öberg S, Rosenberg J (2019) Treatment of longstanding groin pain: a systematic review. Hernia [Internet] 23:1035–1044. https://doi.org/10.1007/s10029-019-01919-7

  11. Sheen AJ, Stephenson BM, Lloyd DM, Robinson P, Fevre D, Paajanen H et al (2014) “Treatment of the Sportsman”s groin’: British Hernia Society’s 2014 position statement based on the Manchester Consensus Conference. British Journal of Sports Medicine [Internet] 48:1079–1087. https://doi.org/10.1136/bjsports-2013-092872

  12. Ramanan B, Maloley BJ, Fitzgibbons RJ Jr (2014) Inguinal hernia: follow or repair? Adv Surg [Internet] 48:1–11. https://doi.org/10.1016/j.yasu.2014.05.017

  13. Schroeder AD, Tubre DJ, Fitzgibbons RJ Jr (2019) Watchful waiting for inguinal hernia. Adv Surg [Internet] 53:293–303. https://doi.org/10.1016/j.yasu.2019.04.014

  14. Reistrup H, Fonnes S, Rosenberg J (2021) Watchful waiting vs repair for asymptomatic or minimally symptomatic inguinal hernia in men: a systematic review. Hernia [Internet] 25(5):1121–1128. https://doi.org/10.1007/s10029-020-02295-3

  15. Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, Dunlop DD, Reda DJ, McCarthy M Jr et al (2006) Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA [Internet] 295(3):285–292. https://doi.org/10.1001/jama.295.3.285

  16. Sarosi GA, Wei Y, Gibbs JO, Reda DJ, McCarthy M, Fitzgibbons RJ et al (2011) A clinician’s guide to patient selection for watchful waiting management of inguinal hernia. Ann Surg [Internet] 253(3):605–610. https://doi.org/10.1097/SLA.0b013e31820b04e9

  17. Gong W, Li J (2018) Operation versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias: the meta-analysis results of randomized controlled trials. Int J Surg [Internet] 52:120–125. https://doi.org/10.1016/j.ijsu.2018.02.030

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Authors and Affiliations

  1. Department of Abdominal Wall and Reconstructive Microsurgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina

    Rubén Emilio Díaz, Santiago Bertone, Sebastián Roche & Claudio Darío Brandi

  2. Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina

    Franco Alejandro Corvatta

Authors
  1. Franco Alejandro Corvatta
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  2. Rubén Emilio Díaz
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  3. Santiago Bertone
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  4. Sebastián Roche
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  5. Claudio Darío Brandi
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Contributions

F.A.C.: Conceptualization, formal analysis, writing—review & editing; R.E.D.: Resources, writing—review & editing; S.B.: Resources, supervision; S.R.: Resources, supervision; C.D.B.: Project administration, resources, supervision.

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Correspondence to Franco Alejandro Corvatta.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The local Research Ethics Committee has confirmed that no ethical approval is required for case reports.

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The authors declare no competing interests.

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Corvatta, F.A., Díaz, R.E., Bertone, S. et al. Management of groin hernias detected by ultrasound: a comprehensive study. Langenbecks Arch Surg 408, 408 (2023). https://doi.org/10.1007/s00423-023-03146-2

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