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Prone “computed tomography hernia study” for the diagnosis of inguinal hernia

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Abstract

Purpose

To improve diagnostic accuracy in cases of a suspected inguinal hernia, we perform a “CT hernia study,” with the patient lying prone to allow decompression of the structures in the inguinal region.

Methods

We reviewed the records of 914 patients with a suspected inguinal hernia who underwent prone non-contrast lower abdominal CT with two rolled-up towels, 20 cm in diameter, placed transversely beneath them, at the umbilicus and hips, respectively.

Results

The CT hernia study yielded a diagnosis of inguinal hernia in 861 (94.2%) patients and a condition other than inguinal hernia in 43 (4.7%) patients. Hernia was not detected preoperatively but found intraoperatively in 10 patients (1.1%). Surgery was performed for a collective total of 1029 hernias in 873 patients, and the CT hernia study-based hernia detection rate was 98.3%. We compared the preoperative diagnoses of various types of hernia (Japanese Hernia Society Types I–V) against the intraoperative diagnoses and found that the CT hernia study yielded 95.8% accuracy.

Conclusion

The CT hernia study appears to provide a high detection rate and makes differentiating the various types of inguinal hernia possible. We believe our CT hernia study adds a level of objectivity that is diagnostically beneficial.

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Authors and Affiliations

  1. Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, 2-16-1Miyamae-ku, SugaoKawasaki, 216-8511, Kanagawa, Japan

    Natsuko Kamei, Takehito Otsubo & Satoshi Koizumi

  2. Department of Radiology, St. Marianna University School of Medicine, 2-16-1Miyamae-ku, SugaoKawasaki, 216-8511, Kanagawa, Japan

    Tsuyoshi Morimoto & Yasuo Nakajima

Authors
  1. Natsuko Kamei
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  2. Takehito Otsubo
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  3. Satoshi Koizumi
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  4. Tsuyoshi Morimoto
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  5. Yasuo Nakajima
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Corresponding author

Correspondence to Takehito Otsubo.

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NK declares no conflict of interest. TO declares no conflict of interest. SK declares no conflict of interest. TM declares no conflict of interest. YN declares no conflict of interest.

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Kamei, N., Otsubo, T., Koizumi, S. et al. Prone “computed tomography hernia study” for the diagnosis of inguinal hernia. Surg Today 49, 936–941 (2019). https://doi.org/10.1007/s00595-019-01837-2

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  • DOI: https://doi.org/10.1007/s00595-019-01837-2

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