DECOMP Report: Answers surgeons expect from an abdominal wall imaging exam

Area of Science:

• General Surgery
• Radiology
• Medical Imaging

Background:

• Abdominal wall (AW) hernias are common surgical issues with high recurrence and complication rates.
• Clinical diagnosis alone is insufficient for optimal surgical planning.
• Preoperative assessment of hernia characteristics and patient comorbidities is increasingly important.

Purpose of the Study:

• To define essential information regarding abdominal wall hernias for preoperative CT reporting.
• To improve communication between radiologists and surgeons for better hernia repair outcomes.
• To establish a standardized CT reporting structure for abdominal wall hernias.

Main Methods:

• A consensus group of surgeons and radiologists convened to identify key CT findings for AW hernias.
• Discussion focused on hernia size, location, rectus diastase, muscle atrophy, and proportion relative to the AW.
• A structured reporting template was developed based on expert consensus.

Main Results:

• CT is the optimal imaging modality for detailed assessment of AW hernias.
• Specific CT findings (size, location, muscle status) guide surgical technique selection (open vs. MIS, mesh placement, adjunct therapies).
• Current CT reports often lack essential AW hernia information due to radiologist unfamiliarity.

Conclusions:

• Standardized CT reporting of AW hernias is necessary for effective preoperative planning.
• Improved radiologic reporting will enhance surgical decision-making, leading to better hernia repair results.
• The proposed structured report facilitates accurate description and interpretation of AW hernia findings on CT.