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Hernia sacs: is histological examination necessary?
1Department of Laboratory Medicine and Pathobiology, University of Toronto, , Toronto, Ontario, Canada.
Journal of Clinical Pathology
|June 25, 2013
Summary
Microscopic examination of hernia sacs can reveal unexpected diagnoses. While abdominal and femoral hernias require histological submission, inguinal hernias may be examined at the pathologist's discretion.
Area of Science:
- Pathology
- Surgical Pathology
- Oncology
Background:
- Hernia sacs are common surgical specimens.
- Pathological examination guidelines vary for different hernia types.
- Unexpected findings can occur in hernia sacs.
Purpose of the Study:
- To evaluate the diagnostic yield of examining hernia sacs.
- To validate current recommendations for histological submission of hernia sacs.
- To determine the necessity of routine histology for inguinal hernias.
Main Methods:
- Retrospective review of 1426 hernia sac specimens.
- Analysis of inguinal, femoral, and abdominal wall hernias.
- Correlation of pathological findings with clinical information.
Main Results:
- Most pathologies were clinically known (e.g., bowel, lipomas, omentum).
- Malignancies were found in 0.38% of inguinal and 1.2% of abdominal hernias.
- Five malignancies were only detected on microscopic examination.
Conclusions:
- Gross examination of all hernia sacs is recommended.
- Histological submission for abdominal and femoral hernias is advised.
- Pathologist discretion for inguinal hernia histology is supported by findings.
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