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Clinical examination and computed tomography (CT) show good agreement for diagnosing incisional hernias. CT in the supine position offers the highest agreement, aiding diagnosis, especially in overweight patients.

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Area of Science:

  • Abdominal Surgery
  • Diagnostic Imaging
  • Surgical Complications

Background:

  • Incisional hernias are commonly diagnosed via clinical examination.
  • No other diagnostic modality has been definitively proven to aid in diagnosis.

Purpose of the Study:

  • To investigate the correlation between clinical examination findings and computed tomography (CT) in detecting incisional hernias after midline incisions.

Main Methods:

  • Patients underwent clinical examination by three surgeons.
  • Computed tomography (CT) was performed with patients in supine and prone positions.
  • Inter-observer agreement was assessed using Fleiss Kappa values.

Main Results:

  • Clinical examination showed a Kappa of 0.81.
  • CT in the supine position yielded a Kappa of 0.94; prone position yielded 0.89.
  • Combined clinical examination and CT had a Kappa of 0.80.

Conclusions:

  • A consistent definition of incisional hernia can be applied to both clinical examination and CT.
  • Very good agreement exists between clinical examination and CT (supine or prone).
  • CT in the supine position demonstrates the highest inter-observer agreement; it may aid diagnosis in overweight patients.