INVESTIGATING THE EFFICACY OF DIAGNOSTIC ULTRASOUND IN DETECTING OCCULT INGUINAL HERNIA AMONG INGUINAL PAIN PATIENTS: A SINGLE-CENTRE INCIDENCE EVALUATION STUDY
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Keywords
Ultrasound, Hernia, Inguinal, Groin pain
Abstract
Objective: To determine the frequency of occult inguinal hernia identified through ultrasound among individuals presenting with inguinal pain.
Materials and Methods: This descriptive observational study assessed the presence of occult inguinal hernias in 90 male patients with chronic recurrent inguinal pain at Department of Radiology, Chandka Medical College Hospital, Shaheed Muhtarma Benazeer Bhutto Medical University, Larkana, Pakistan in the duration from March,2023 to February, 2024. Total Patients aged 18 to 80 years were included, excluding those with visible hernias. Written consent was obtained, and the study was approved by the institutional ethical committee. Patients underwent physical examinations and ultrasonographic evaluations using a 5-10 MHz linear probe. Diagnostic criteria for groin hernias on ultrasound included visualization of a hernia sac containing bowel or omentum and a positive cough/Valsalva impulse.
Results: In a study involving 90 consecutive male patients with groin pain, the mean age was 53.1±15.7 years. Of these patients, 22.22% experienced bilateral groin pain, 36.67% had left-sided pain, and 41.11% reported right-sided pain. Further assessment identified occult inguinal hernias in 32.2% of the patients, with bilateral involvement in 10.34%, left-sided hernias in 24.14%, and right-sided hernias in 65.52%. Analysis of hernia defect sizes revealed a mean size of 3.25 mm on the right side and 4.89 mm on the left side among patients with occult hernias.
Conclusion: It is evident that ultrasound emerges as a cornerstone in the diagnosis of occult inguinal hernias, offering clinicians a reliable means to identify and manage these conditions effectively. By leveraging ultrasound alongside thorough clinical examination, healthcare providers can ensure accurate diagnosis and tailored treatment plans for patients presenting with groin pain.
References
2. Muschaweck U, Koch A. [Sportsmen's groin : Definition, differential diagnosis and treatment]. Radiologe. 2019 Mar;59(3):224-233. [PubMed] [Reference list]
3. Jenkins, J. T., & O'Dwyer, P. J. (2008). Inguinal hernias. BMJ (Clinical research ed.), 336(7638), 269–272. https://doi.org/10.1136/bmj.39450.428275.AD
4. Mouravas V, Sfoungaris D. The etiology of indirect inguinal hernia in adults: congenital, acquired or both? Hernia. 2015 Dec;19(6):1037-8. [PubMed] [Reference list]
5. Jiang ZP, Yang B, Wen LQ, Zhang YC, Lai DM, Li YR, Chen S. The etiology of indirect inguinal hernia in adults: congenital or acquired? Hernia. 2015 Oct;19(5):697-701. [PubMed] [Reference list]
6. HerniaSurge Group (2018). International guidelines for groin hernia management. Hernia : the journal of hernias and abdominal wall surgery, 22(1), 1–165. https://doi.org/10.1007/s10029-017-1668-x
7. Pandya, B., Huda, T., Gupta, D., Mehra, B., & Narang, R. (2021). Abdominal Wall Hernias: An Epidemiological Profile and Surgical Experience from a Rural Medical College in Central India. Surgery journal (New York, N.Y.), 7(1), e41–e46. https://doi.org/10.1055/s-0040-1722744
8. Lau, H., Fang, C., Yuen, W. K., & Patil, N. G. (2007). Risk factors for inguinal hernia in adult males: a case-control study. Surgery, 141(2), 262–266. https://doi.org/10.1016/j.surg.2006.04.014
9. Ansede, G., English, B., & Healy, J. C. (2011). Groin pain: clinical assessment and the role of MR imaging. Seminars in musculoskeletal radiology, 15(1), 3–13. https://doi.org/10.1055/s-0031-1271955
10. Lentz, B., Fong, T., Rhyne, R., & Risko, N. (2021). A systematic review of the cost-effectiveness of ultrasound in emergency care settings. The ultrasound journal, 13(1), 16. https://doi.org/10.1186/s13089-021-00216-8
11. Paajanen H, Ojala S, Virkkunen A. Incidence of occult inguinal and Spigelian hernias during laparoscopy of other reasons. Surgery. 2006 Jul; 140(1):9-12; discussion 12-3. doi: 10.1016/j.surg.2006.01.005
12. Ruhl CE and Everhart JE. Risk factors for inguinal hernia among adults in the US population. American Journal of Epidemiology. 2007 May; 165(10):1154-61. doi: 10.1093/aje/kwm011.
13. Bradley M, Morgan J, Pentlow B, Roe A. The positive predictive value of diagnostic ultrasound for occult herniae. Annals of the Royal College of Surgeons of England. 2006 Mar; 88(2):165-7. doi: 10.1308/0035884 06X95110.
14. Alam A, Nice C, Uberoi R. The accuracy of ultrasound in the diagnosis of clinically occult groin hernias in adults. European radiology. 2005 Dec; 15(12):2457-61. doi: 10.1007/s00330-005-2825-7.
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Dr Kailash Kumar Daseja
Assistant Professor, Department of Radiology, Chandka Medical College Hospital, Shaheed Muhtarma Benazeer Bhutto Medical University, Larkana, Pakistan
Dr. Mohsin Hussain
Assistant Professor, Department of Radiology, Pir Abdul Qadir Shah Jeelani institute of Medical Science, Gambat, Khairpur Mirs, Pakistan
Dr Din Muhammad Sohu
Assistant Professor, Department of Radiology, Chandka Medical College Hospital, Shaheed Muhtarma Benazeer Bhutto Medical University, Larkana, Pakistan
Dr. Nadia Bhatti
Senior Registrar, Department of Surgery, Chandka Medical College Hospital, Shaheed Muhtarma Benazeer Bhutto Medical University, Larkana, Pakistan
Dr Altaf-U-Rehman Sodhar
Post Graduate of MCPS, Department of Radiology, Chandka Medical College Hospital, Shaheed Muhtarma Benazeer Bhutto Medical University, Larkana, Pakistan
Dr Anzar Farooq Shaikh
Post Graduate of DMRD, Department of Radiology, Chandka Medical College Hospital, Shaheed Muhtarma Benazeer Bhutto Medical University, Larkana, Pakistan