Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, 2-16-1Miyamae-ku, SugaoKawasaki, 216-8511, Kanagawa, Japan.
Department of Radiology, St. Marianna University School of Medicine, 2-16-1Miyamae-ku, SugaoKawasaki, 216-8511, Kanagawa, Japan.
Surg Today. 2019 Nov;49(11):936-941. doi: 10.1007/s00595-019-01837-2. Epub 2019 Jun 26.
To improve diagnostic accuracy in cases of a suspected inguinal hernia, we perform a "CT hernia study," with the patient lying prone to allow decompression of the structures in the inguinal region.
We reviewed the records of 914 patients with a suspected inguinal hernia who underwent prone non-contrast lower abdominal CT with two rolled-up towels, 20 cm in diameter, placed transversely beneath them, at the umbilicus and hips, respectively.
The CT hernia study yielded a diagnosis of inguinal hernia in 861 (94.2%) patients and a condition other than inguinal hernia in 43 (4.7%) patients. Hernia was not detected preoperatively but found intraoperatively in 10 patients (1.1%). Surgery was performed for a collective total of 1029 hernias in 873 patients, and the CT hernia study-based hernia detection rate was 98.3%. We compared the preoperative diagnoses of various types of hernia (Japanese Hernia Society Types I-V) against the intraoperative diagnoses and found that the CT hernia study yielded 95.8% accuracy.
The CT hernia study appears to provide a high detection rate and makes differentiating the various types of inguinal hernia possible. We believe our CT hernia study adds a level of objectivity that is diagnostically beneficial.
为了提高疑似腹股沟疝患者的诊断准确性，我们进行“CT 疝研究”，让患者俯卧位，以减轻腹股沟区域结构的压力。
我们回顾了 914 例疑似腹股沟疝患者的记录，这些患者接受了俯卧位非对比下腹部 CT 检查，在他们的脐部和臀部分别放置了两个直径 20 厘米的卷起的毛巾。
CT 疝研究在 861 例（94.2%）患者中诊断为腹股沟疝，在 43 例（4.7%）患者中诊断为腹股沟疝以外的疾病。术前未发现疝，但在 10 例患者（1.1%）中发现。在 873 例患者中共进行了 1029 例疝手术，CT 疝研究的疝检出率为 98.3%。我们比较了各种类型疝（日本疝学会类型 I-V）的术前诊断与术中诊断，发现 CT 疝研究的准确率为 95.8%。
CT 疝研究似乎提供了较高的检出率，并能够区分各种类型的腹股沟疝。我们认为，我们的 CT 疝研究增加了诊断有益的客观性。
