Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland,
Hernia. 2014 Aug;18(4):597-600. doi: 10.1007/s10029-012-1038-7. Epub 2013 Jan 18.
A 24-year-old man underwent laparoscopic mesh repair of a right direct inguinal hernia which had recurred after previous surgery 3 months previously. A large swelling was noted in the right groin 4 h postoperatively, which was reduced initially but recurred within 24 h. A differential diagnosis of postoperative recurrence versus hematoma was considered, and patient was referred for imaging.
The patient was imaged using different modalities including B-mode ultrasonography, computed tomography (CT) of the pelvis, and True-FISP magnetic resonance imaging (true imaging with steady-state precession MRI).
Initial focused ultrasound (US) [corrected] was suggestive of but equivocal for recurrence. Subsequent non-contrast CT of the region followed by rapid sequence (true-FISP) MRI confirmed the presence of bowel in the inguinal canal.
Imaging has a role in the diagnosis of postoperative hernia recurrence in cases where there is a clinical diagnostic dilemma, especially MRI using true-FISP sequence, which is acquired in seconds, is a non-ionising radiation modality and does not have inter operator variability.
一名 24 岁男性因 3 个月前接受的腹腔镜网片修补右侧腹股沟直疝复发而行手术。术后 4 小时，患者右侧腹股沟出现巨大肿胀，最初有所缓解，但在 24 小时内再次复发。考虑到术后复发与血肿的鉴别诊断，患者接受了影像学检查。
患者接受了多种影像学检查，包括 B 型超声、骨盆 CT 和 True-FISP 磁共振成像（稳态进动 MRI 的真实成像）。
最初的聚焦超声（US）检查结果提示复发，但结果不确定。随后对该区域进行非增强 CT 检查，然后进行快速序列（True-FISP）MRI 检查，证实了肠管位于腹股沟管内。
对于存在临床诊断难题的术后疝复发病例，影像学检查具有一定作用，特别是使用 True-FISP 序列的 MRI，该序列可在数秒内获得，是非电离辐射模态，且不存在操作者间差异。
