Abdominal wall hernias: review of herniography and correlation with cross-sectional imaging

Herniography is an accurate means of identifying groin hernias when the clinical diagnosis is uncertain. Its role in evaluation of other types of ventral hernias is less clear; however, with minor modifications in technique, herniography is also useful in these cases. This article reviews the technique of herniography, normal variations in anatomy, and interpretation of herniograms of the groin and anterior abdominal wall on the basis of 72 patients studied over 3 1/2 years. Herniography is also compared with cross-sectional imaging techniques. Inguinal and femoral hernias are best shown and classified with herniography. Ventral hernias are well demonstrated by both herniography and cross-sectional imaging; however, herniation of only fat and supine imaging may lead to misdiagnosis with computed tomography or ultrasound. Spigelian hernias are probably best depicted with cross-sectional imaging. Diagnostic pitfalls of herniography are reviewed, including the need for obtaining postexercise radiographs, oblique radiographs, and tangential radiographs.