Audit of ultrasound and decision to operate in groin pain of unknown aetiology with ultrasound technique explained.
OBJECTIVE
To determine the ability of a groin ultrasound service to identify inguinal/femoral hernias in patients with groin pain and equivocal clinical signs, and to evaluate the number of positive cases undergoing surgery.


METHODS
A retrospective review of 243 examinations performed during the period January 2000 to June 2004 was undertaken. The referral information, as well as details of the examination and subsequent follow-up, were obtained through our hospital/radiological information system.


RESULTS
Of 243 patients, 92 (38%) were referrals from general practitioners and 151 (62%) were hospital referrals. The examinations were performed by radiology consultants or specialist registrars, the former accounting for 228 examinations (94%). The age range of the patients was 3 months to 88 years (mean age=48.7), with a male to female ratio of 3.2:1. One hundred and forty-three examinations were negative for hernias. Two of these patients underwent groin explorations and were found to be normal. The rest were discharged and none returned with related complaints. Ninety-four examinations (39%) were positive for hernias, as a result of which 62 patients underwent surgery. Of these, only four were found to be false-positives giving a positive predictive value of 94% in operated patients. Three scans were equivocal, and three were positive for other conditions.


CONCLUSIONS
In patients with equivocal clinical signs, groin ultrasound is a useful tool for identifying hernias, and therefore, aids surgical management.
Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Chester, Cheshire, UK. ruben.depasquale@gmail.com
R
R
Depasquale
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C
Landes
G
G
Doyle
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D003937:Diagnosis, Differential; D005260:Female; D006119:Groin / Q000000981:diagnostic imaging / Q000601:surgery; D006550:Hernia, Femoral / Q000000981:diagnostic imaging* / Q000601:surgery; D006552:Hernia, Inguinal / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging / Q000601:surgery; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult