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Ultrasonographic evaluation of bilateral groins in children with unilateral inguinal hernia
R Kervancioglu1, M M Bayram, I Ertaskin
1Department of Radiology, Gaziantep University, School of Medicine, Sahinbey Hospital, Turkey.
Insights
Ultrasound (US) accurately diagnoses inguinal hernias in children. A patent processus vaginalis (PPV) measurement over 4 mm reliably indicates hernia, aiding pre-operative assessment.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
- Ultrasound Technology
Background:
- Inguinal hernias are common in children, often requiring surgical intervention.
- Accurate pre-operative diagnosis is crucial for effective management and surgical planning.
Purpose of the Study:
- To prospectively evaluate the diagnostic performance of ultrasound (US) in identifying inguinal hernias in children.
- To compare US findings with clinical examination and surgical outcomes.
Main Methods:
- 128 children with suspected unilateral inguinal hernia underwent prospective US examination of both groins.
- The widest diameter of the inguinal canal was measured, with patent processus vaginalis (PPV) values ≥4 mm considered indicative of hernia.
- US and clinical findings were compared with surgical exploration results.
Main Results:
- Ultrasound correctly diagnosed 131 out of 138 groins (94.9% accuracy).
- US demonstrated high sensitivity (95.4%) and specificity (85.7%) for hernia detection.
- The accuracy of physical examination was 87.7%; US identified 10 cases of bilateral hernias missed by clinical assessment.
Conclusions:
- Ultrasound is a reliable tool for routine pre-operative diagnosis of inguinal hernias in pediatric patients.
- A patent processus vaginalis (PPV) diameter greater than 4 mm is a highly accurate indicator of inguinal hernia.
Purpose:
The presence of hernia was investigated prospectively by US in both groins of children with clinically suspected or apparent unilateral inguinal hernia.
Material And Methods:
One hundred and twenty-eight (103 boys, 25 girls) were classified into three groups according to age: 0-2, 3-5 and 6-15 years. The widest diameter of the inguinal canal was measured in the longitudinal plane while the children were in the supine position and at rest. The patent processus vaginalis (PPV) values of 4 mm and higher were accepted as hernia. The groins diagnosed clinically and/or ultrasonographically as hernia were explored surgically. The clinical and US findings were compared with surgical results. The relations between hernia diameters and the age groups, sex, right/left and inguinal/scrotal hernias were analyzed statistically.
Results:
In 128 children, 138 groins were treated with surgery. One hundred and eleven cases were unilateral hernia (73 right, 38 left) and 10 were bilateral. Seven cases were found to be normal. Ten cases with clinically unilateral hernia were bilateral at US and surgery. One hundred and thirty-one of 138 groins were correctly diagnosed by US. The accuracy, specificity and sensitivity of US were 94.9%, 85.7% and 95.4%, respectively. The accuracy of physical examination was 87.7%. There were no significant differences between hernia diameters and the age groups, sex and right/left side except the difference between inguinal and scrotal hernia diameters (p<0.0001).
Conclusion:
US can be used routinely in the pre-operative diagnosis of inguinal hernia in children. PPV values higher than 4 mm, with a high accuracy indicate hernia.