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Combined Supine and Standing Imaging for Varicocele: An Improved Diagnostic Approach
Published on: November 22, 2024
Inguinal hernias can be accurately diagnosed using the parent's digital photographs when the physical examination is
Akemi L Kawaguchi1, Donald B Shaul
1Department of Pediatric Surgery, University of Southern California, Los Angeles, CA 90027, USA. akawaguchi@chla.usc.edu
Insights
Preoperative photos reliably confirm inguinal hernias in children when physical exams are inconclusive. This method avoids repeat visits, saving time and expense for families and physicians.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
Background:
- Inguinal hernias in infants and children can be difficult to diagnose during clinical examinations.
- Preoperative photographic evidence may improve diagnostic accuracy.
Purpose of the Study:
- To assess the accuracy of preoperative photographic evidence in diagnosing inguinal hernias in pediatric patients.
- To evaluate the utility of photographic confirmation when physical examination is inconclusive.
Main Methods:
- Retrospective review of 25 pediatric patients with suspected inguinal hernias over 30 months.
- Clinical examination followed by parental submission of photographs if no bulge was detected.
- Surgical intervention based on history and photographic evidence.
Main Results:
- 23 out of 25 patients with suspected inguinal hernias underwent surgery based on history and imaging.
- All surgically treated patients had operatively confirmed inguinal hernias.
- Two patients were managed conservatively and did not develop hernias.
Conclusions:
- Preoperative photographic images are a reliable tool for confirming inguinal hernias and their laterality in pediatric patients.
- Utilizing digital image transmission reduces the need for repeat office visits, saving significant time and costs.
Purpose:
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.
Conclusion:
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.
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