title: Inguinal hernias can be accurately diagnosed using the parent's digital photographs when the physical examination is nondiagnostic.
abstract: OBJECTIVE
  Inguinal hernias in infants and children may not be evident during visits to the pediatric surgeon's office. Preoperative photographic confirmation of the hernia may be helpful and accurate. This study retrospectively assesses the preoperative examination, photographic evidence, operative findings, and complications of these patients.
  
  
  METHODS
  For a 30-month period, children with a history of a possible inguinal bulge were assessed by clinical examination. If no bulge was detected, the parents were given the option of sending a photograph to the surgeon. Patients underwent surgery based solely upon the history and definitive image.
  
  
  RESULTS
  For 30 months, 25 children were evaluated for inguinal pathology but had no hernia on clinical examination. Based solely upon the history and the digital image, 23 of these patients underwent surgery. All of the patients who were diagnosed with a hernia by history and imaging alone had an operatively confirmed hernia. The remaining 2 patients have not developed a hernia with continued observation.
  
  
  CONCLUSIONS
  Photographic images are a reliable way to document the presence and laterality of inguinal hernias. Reliance upon digital transmission of images avoids the need for repeat office visits, saving considerable physician and parental time and expense.
authors.affiliation: Department of Pediatric Surgery, University of Southern California, Los Angeles, CA 90027, USA. akawaguchi@chla.usc.edu
authors.forename: Akemi L
authors.initials: AL
authors.lastname: Kawaguchi
authors.forename: Donald B
authors.initials: DB
authors.lastname: Shaul
mesh_terms: D040421:Cell Phone / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D034742:Electronic Mail / Q000706:statistics & numerical data; D005260:Female; D007839:Functional Laterality; D006119:Groin / Q000473:pathology; D006552:Hernia, Inguinal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008487:Medical History Taking; D009819:Office Visits; D010290:Parents; D010781:Photography / Q000379:methods*; D010808:Physical Examination / Q000379:methods*; D011300:Preoperative Care; D012189:Retrospective Studies