Korenkov M, Paul A, Troidl H
II Department of Surgery, University of Cologne, Germany.
J Ultrasound Med. 1999 Aug;18(8):565-8. doi: 10.7863/jum.1999.18.8.565.
We investigated the accuracy of combined physical and color duplex sonographic examination in the preoperative distinction of direct inguinal hernias. After a learning period (with 15 male patients) 50 consecutive male patients who underwent surgery in our department for small inguinal hernias between July 1995 and April 1996 were examined. On color duplex examination the relationship between the hernial sac and the inferior epigastric artery was determined. Intraoperative results were then compared with the data obtained preoperatively. The sensitivity of our physical examination for direct inguinal hernia was 75% with a specificity and a positive predictive value of 100% and a negative predictive value of 80%. The identification of the IEA as well as the hernial sac was successful on every color duplex sonographic study. The sensitivity of color duplex sonography for direct inguinal hernias amounted to 90%, the specificity was 86%, the positive predictive value was 78%, and the negative predictive value was 89%. Both combined hernias found intraoperatively had not been detected either by physical examination or by color duplex examination. Correspondence of results obtained by physical examination and color duplex examination leads to high accuracy in the diagnosis of direct inguinal hernias.
我们研究了体格检查与彩色双功超声检查相结合在术前鉴别腹股沟直疝中的准确性。经过一个学习阶段（对15例男性患者）后，对1995年7月至1996年4月间在我科接受小型腹股沟疝手术的50例连续男性患者进行了检查。在彩色双功超声检查中，确定疝囊与腹壁下动脉之间的关系。然后将术中结果与术前获得的数据进行比较。我们的体格检查对腹股沟直疝的敏感性为75%，特异性和阳性预测值为100%，阴性预测值为80%。在每一项彩色双功超声检查中，均成功识别出腹壁下动脉和疝囊。彩色双功超声对腹股沟直疝的敏感性为90%，特异性为86%，阳性预测值为78%，阴性预测值为89%。术中发现的两例复合疝，体格检查和彩色双功超声检查均未检测到。体格检查和彩色双功超声检查结果的一致性导致腹股沟直疝诊断的高准确性。
