Advertisement

Diagnostic Tools in Hernia Disease

  • Paul Tenzel
  • Jordan Bilezikian
  • William W. Hope
Chapter

Abstract

Although the majority of inguinal and ventral hernias can be diagnosed using history and physical, imaging modalities are often used in hernia disease to confirm diagnosis or to diagnose occult hernias, to assist in operative planning of complex hernia repairs, and to follow up patients for recurrence and to evaluate for causes of chronic pain after hernia repair. Several imaging modalities commonly used include ultrasound, computed tomography (CT) scanning, and magnetic resonance imaging (MRI). Each of these modalities has a place in the evaluation of hernia disease with the use tailored to the information needed and based on the clinical scenario. This chapter reviews the imaging modalities commonly used in inguinal and ventral/incisional hernia disease including recommendations for their use.

References

  1. 1.
    Robinson A, Light D, Kasim A, Nice C. A systematic review and meta-analysis of the role of radiology in the diagnosis of occult inguinal hernia. Surg Endosc. 2013;27(1):11–8.  https://doi.org/10.1007/s00464-012-2412-3.CrossRefPubMedGoogle Scholar
  2. 2.
    Light D, Ratnasingham K, Banerjee A, Cadwallader R, Uzzaman MM, Gopinath B. The role of ultrasound scan in the diagnosis of occult inguinal hernias. Int J Surg. 2011;9(2):169–72.  https://doi.org/10.1016/j.ijsu.2010.10.014.CrossRefPubMedGoogle Scholar
  3. 3.
    Alabraba E, Psarelli E, Meakin K, Quinn M, Leung M, Hartley M, et al. The role of ultrasound in the management of patients with occult groin hernias. Int J Surg. 2014;12(9):918–22.  https://doi.org/10.1016/j.ijsu.2014.07.266.CrossRefPubMedGoogle Scholar
  4. 4.
    Miller J, Cho J, Michael MJ, Saouaf R, Towfigh S. Role of imaging in the diagnosis of occult hernias. JAMA Surg. 2014;149(10):1077–80.  https://doi.org/10.1001/jamasurg.2014.484.CrossRefPubMedGoogle Scholar
  5. 5.
    Markos V, Brown EF. CT herniography in the diagnosis of occult groin hernias. Clin Radiol. 2005;60(2):251–6.  https://doi.org/10.1016/j.crad.2004.02.013.CrossRefPubMedGoogle Scholar
  6. 6.
    Garvey JF. Computed tomography scan diagnosis of occult groin hernia. Hernia. 2012;16(3):307–14.  https://doi.org/10.1007/s10029-011-0899-5.CrossRefPubMedGoogle Scholar
  7. 7.
    Ducharme JC, Bertrand R, Chacar R. Is it possible to diagnose inguinal hernia by X-ray? A preliminary report on herniography. J Can Assoc Radiol. 1967;18(4):448–51.PubMedGoogle Scholar
  8. 8.
    Ng TT, Hamlin JA, Kahn AM. Herniography: analysis of its role and limitations. Hernia. 2009;13(1):7–11.  https://doi.org/10.1007/s10029-008-0423-8.CrossRefPubMedGoogle Scholar
  9. 9.
    Hureibi KA, McLatchie GR, Kidambi AV. Is herniography useful and safe? Eur J Radiol. 2011;80(2):e86–90.  https://doi.org/10.1016/j.ejrad.2010.08.017.CrossRefPubMedGoogle Scholar
  10. 10.
    Beck WC, Holzman MD, Sharp KW, Nealon WH, Dupont WD, Poulose BK. Comparative effectiveness of dynamic abdominal sonography for hernia vs computed tomography in the diagnosis of incisional hernia. J Am Coll Surg. 2013;216(3):447–53. quiz 510-1.  https://doi.org/10.1016/j.jamcollsurg.2012.11.012.CrossRefPubMedGoogle Scholar
  11. 11.
    Baucom RB, Beck WC, Phillips SE, Holzman MD, Sharp KW, Nealon WH, et al. Comparative evaluation of dynamic abdominal sonography for hernia and computed tomography for characterization of incisional hernia. JAMA Surg. 2014;149(6):591–6.  https://doi.org/10.1001/jamasurg.2014.36.CrossRefPubMedGoogle Scholar
  12. 12.
    Blair LJ, Ross SW, Huntington CR, Watkins JD, Prasad T, Lincourt AE, et al. Computed tomographic measurements predict component separation in ventral hernia repair. J Surg Res. 2015;199(2):420–7.  https://doi.org/10.1016/j.jss.2015.06.033.CrossRefPubMedGoogle Scholar
  13. 13.
    Franklin BR, Patel KM, Nahabedian MY, Baldassari LE, Cohen EI, Bhanot P. Predicting abdominal closure after component separation for complex ventral hernias: maximizing the use of preoperative computed tomography. Ann Plast Surg. 2013;71(3):261–5.  https://doi.org/10.1097/SAP.0b013e3182773915.CrossRefPubMedGoogle Scholar
  14. 14.
    Xu Z, Asman AJ, Baucom RB, Abramson RG, Poulose BK, Landman BA. Quantitative CT imaging of ventral hernias: preliminary validation of an anatomical labeling protocol. PLoS One. 2015;10(10):e0141671.  https://doi.org/10.1371/journal.pone.0141671.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Yao S, Li JY, Liu FD, Pei LJ. Significance of measurements of herniary area and volume and abdominal cavity volume in the treatment of incisional hernia: application of CT 3D reconstruction in 17 cases. Comput Aided Surg. 2012;17(1):40–5.  https://doi.org/10.3109/10929088.2011.636453.CrossRefPubMedGoogle Scholar
  16. 16.
    Langbach O, Holmedal SH, Grandal OJ, Rokke O. Adhesions to mesh after ventral hernia mesh repair are detected by MRI but are not a cause of long term chronic abdominal pain. Gastroenterol Res Pract. 2016;2016:2631598.  https://doi.org/10.1155/2016/2631598.CrossRefPubMedGoogle Scholar
  17. 17.
    Lienemann A, Sprenger D, Steitz HO, Korell M, Reiser M. Detection and mapping of intraabdominal adhesions by using functional cine MR imaging: preliminary results. Radiology. 2000;217(2):421–5.  https://doi.org/10.1148/radiology.217.2.r00oc23421.CrossRefPubMedGoogle Scholar
  18. 18.
    Buhmann-Kirchhoff S, Lang R, Kirchhoff C, Steitz HO, Jauch KW, Reiser M, et al. Functional cine MR imaging for the detection and mapping of intraabdominal adhesions: method and surgical correlation. Eur Radiol. 2008;18(6):1215–23.  https://doi.org/10.1007/s00330-008-0881-5.CrossRefPubMedGoogle Scholar
  19. 19.
    Fischer T, Ladurner R, Gangkofer A, Mussack T, Reiser M, Lienemann A. Functional cine MRI of the abdomen for the assessment of implanted synthetic mesh in patients after incisional hernia repair: initial results. Eur Radiol. 2007;17(12):3123–9.  https://doi.org/10.1007/s00330-007-0678-y.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Paul Tenzel
    • 1
  • Jordan Bilezikian
    • 1
  • William W. Hope
    • 1
  1. 1.Department of SurgeryNew Hanover Regional Medical CenterWilmingtonUSA

Personalised recommendations