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著者: Natsuko Kamei, Takehito Otsubo, Satoshi Koizumi, Tsuyoshi Morimoto, Yasuo Nakajima
雑誌名: Surg Today. 2019 Nov;49(11):936-941. doi: 10.1007/s00595-019-01837-2. Epub 2019 Jun 26.
Abstract/Text
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.
PMID 31243553 Surg Today. 2019 Nov;49(11):936-941. doi: 10.1007/s00595-019-01837-2. Epub 2019 Jun 26.
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