Abdominal CT of inguinal hernia

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Author: Mikael Häggström [notes 1]

Indirect inguinal hernia (through the inguinal canal).

Planning

Indication for imaging

In strong abdominal pain, a suspected strangulated hernia indicates surgery without previous medical imaging.

A physician may diagnose an inguinal hernia, as well as the type, from medical history and physical examination.[1] Imaging is therefore indicated for confirmation or in uncertain cases.

Choice of modality

  • Ultrasonography of inguinal hernia is otherwise generally the initial choice of investigation, since it can diagnose the condition, in Valsalva maneuver and standing if necessary, as well as being able to determine the ability to reduce any hernias by pressure.[2]
  • Abdominal CT of inguinal hernia is indicated in unspecific abdominal symptoms, in order to better diagnose possible differential diagnoses.

Settings

Prone position, with and without Valsalva maneuver.

Evaluation

Right inguinal hernia
  • Any increased width of the inguinal canal, which normally has a diameter of up to 13 mm at the deep inguinal ring.[3]
  • Any bulging of the abdominal wall at the inguinal triangle, suggesting a direct inguinal hernia.
  • Basic screening of abdominal contents.

Further evaluation

In the presence of inguinal hernia, also determine:

  • Contents, mainly whether it contains only fat, or any intestines or other mesentery.
  • If it contains intestines, also look for signs of intestinal obstruction or strangulation.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. LeBlanc, Kim Edward; LeBlanc, Leanne L; LeBlanc, Karl A (15 June 2013). "Inguinal hernias: diagnosis and management. ". American Family Physician 87 (12): 844–8. PMID 23939566. Archived from the original. . 
  2. Stavros, A. Thomas; Rapp, Cindy (September 2010). "Dynamic Ultrasound of Hernias of the Groin and Anterior Abdominal Wall ". Ultrasound Quarterly 26 (3): 135–169. doi:10.1097/RUQ.0b013e3181f0b23f. PMID 20823750. 
  3. Kumar, Vipin; Patel, Jignesh; Sharma, Chakraprabha; Inkhiya, Suman (2018). "Morphometric Study of Inguinal Canal on Cadaver ". International Journal of Anatomy and Research 6 (2.1): 5172–5175. doi:10.16965/ijar.2018.147. ISSN 23218967.