Groin hernias in adults: value of color Doppler sonography in their classification.
OBJECTIVE
We assessed the abilities of color Doppler and power Doppler sonography to distinguish among types of groin hernias by demonstrating the inferior epigastric artery (IEA) and its relationship with the hernia sac.


METHODS
Nineteen consecutive patients (14 men and 5 women), clinically diagnosed as having groin hernias and scheduled to undergo herniorrhaphy, were prospectively enrolled in this study. Ultrasound examinations were performed preoperatively with a 6-12-MHz linear-array transducer. The IEA was identified, if possible, and its relationship to the hernia sac assessed. The sonographic diagnoses were compared with the operative findings.


RESULTS
There were 15 indirect inguinal hernias, 4 direct inguinal hernias, and 1 femoral hernia; 1 patient had bilateral inguinal hernias (indirect and direct). In 18 (90%) of 20 hernia cases, the trunk segment of the IEA could be visualized. In 11 (55%) of 20 hernia cases, the origin segment of the IEA could be visualized and its relationship with the hernia sac assessed. In 9 (82%) of the 11 hernia cases, hernia types were correctly diagnosed by sonography. The overall accuracy of sonography for diagnosing the type of hernia was 45% (9 of 20 hernias).


CONCLUSIONS
Color Doppler sonography can accurately differentiate types of groin hernias if the origin segment of the IEA and the hernia sac can be visualized simultaneously. However, color Doppler sonography sometimes failed to visualize this segment.
Zhang
G Q
GQ
First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Sugiyama
M
M
Hagi
H
H
Urata
T
T
Shimamori
N
N
Atomi
Y
Y
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D019074:Epigastric Arteries / Q000000981:diagnostic imaging*; D005260:Female; D006550:Hernia, Femoral / Q000000981:diagnostic imaging / Q000601:surgery; D006552:Hernia, Inguinal / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color