Pre-operative imaging for inguinal hernia: routine or waste? A single institution perspective

Inguinal hernia is a very common surgical problem in Australia. This study aims to assess at a single institution the perioperative use of imaging for these patients, and the accuracy of that imaging.

Data were collected retrospectively for 215 adult patients who underwent inguinal hernia repair at a single public hospital. Clinical, operative, and imaging findings were collected and recorded.

The study included 215 patients who had surgery on 240 groins. 90% of patients had preoperative imaging, with 70% undergoing ultrasound, and 28% undergoing CT scan. 82% of patients who had imaging had a clinically palpable hernia. Ultrasound and CT had high sensitivity for the presence of hernia, 97.5% and 90.6%, respectively. Ultrasound was inaccurate at assessing for direct versus indirect hernia, correlating with operative findings only 62% of the time.

Data suggest that imaging is being overused for investigation of groin hernias, and imaging findings do not appear to alter operative management.