Lilly M C, Arregui M E
Department of General Surgery, St. Vincent Hospital and Health Care Center, 8402 Harcourt Road, Indianapolis, IN 46260, USA.
Surg Endosc. 2002 Apr;16(4):659-62. doi: 10.1007/s00464-001-8145-3. Epub 2001 Dec 17.
This study aimed to evaluate the utility of ultrasound in the diagnosis of inguinal hernias and obscure groin pain.
A series of 65 consecutive groin explorations performed subsequently to percutaneous ultrasound examination were prospectively evaluated. Patients were examined in an office setting. The examination included a history and a physical. Then an ultrasound of the inguinal region was performed. Ultrasound was performed by the staff surgeon and fellows. Patients then were taken to surgery for either a laparoscopic or open hernia repair. The preoperative and operative findings were compared to determine the utility of groin ultrasound.
A series of 41 patients presenting with symptoms of groin pain or palpable groin bulge were evaluated with ultrasound of the groin. Of these patients, 24 went on to have bilateral repairs, bringing the study total to 65 groins. Surgery involved 50 laparoscopic and 15 open hernia repairs. This included 20 groins without hernia, as determined by physical examination, and 45 groins with a palpable hernia. Overall, ultrasound was used to identify the type of hernia correctly (direct vs indirect) with 85% success. In the 20 patients who had no palpable bulge, ultrasound identified a protrusion (hernia or lipoma) in 17. Two of these were false positives, and the three negative ultrasound examinations were false negatives. Thus ultrasound identified the pathology in a groin without a palpable bulge at an accuracy of 75%. The overall accuracy in finding a hernia of any kind by ultrasound was 92%.
Ultrasound is a useful adjunct in evaluating the groin for hernia, and can be performed by surgeons.
本研究旨在评估超声在腹股沟疝和不明原因腹股沟疼痛诊断中的应用价值。
对经皮超声检查后连续进行的65例腹股沟探查手术进行前瞻性评估。患者在门诊环境中接受检查。检查包括病史询问和体格检查。然后对腹股沟区域进行超声检查。超声检查由外科主治医师和住院医师完成。随后患者接受腹腔镜或开放式疝修补手术。比较术前和手术结果以确定腹股沟超声的应用价值。
对41例出现腹股沟疼痛症状或可触及腹股沟肿块的患者进行了腹股沟超声检查。其中，24例患者进行了双侧修补手术，使研究总数达到65个腹股沟区。手术包括50例腹腔镜疝修补术和15例开放式疝修补术。其中包括20个经体格检查确定无疝的腹股沟区和45个可触及疝的腹股沟区。总体而言，超声正确识别疝类型（直疝与斜疝）的成功率为85%。在20例无可触及肿块的患者中，超声在17例中发现了突出物（疝或脂肪瘤）。其中2例为假阳性，3例超声检查阴性为假阴性。因此，超声在无可触及肿块的腹股沟区识别病变的准确率为75%。超声发现任何类型疝的总体准确率为92%。
超声是评估腹股沟疝的有用辅助手段，且可由外科医生操作。
