- Universidade Positivo, Clínica Cirúrgica e Cirurgia Minimamente Invasiva - Curitiba - PR - Brasil.
- Hospital Municipal Lourenço Jorge, Clínica Cirúrgica - Rio de Janeiro - RJ - Brasil.
Rev Col Bras Cir. 2022 Apr 27;49:e20223172. doi: 10.1590/0100-6991e-20223172en. eCollection 2022.
Abdominal wall (AW) hernias are a common problem faced by general surgeons. With an essentially clinical diagnosis, abdominal hernias have been considered a simple problem to be repaired. However, long-term follow-up of patients has shown disappointing results, both in terms of complications and recurrence. In this context, preoperative planning with control of comorbidities and full knowledge of the hernia and its anatomical relationships with the AW has gained increasing attention. Computed tomography (CT) appears to be the best option to determine the precise size and location of abdominal hernias, presence of rectus diastase and/or associated muscle atrophy, as well as the proportion of the hernia in relation to the AW itself. This information might help the surgeon to choose the best surgical technique (open vs MIS), positioning and fixation of the meshes, and eventual need for application of botulinum toxin, preoperative pneumoperitoneum or component separation techniques. Despite the relevance of the findings, they are rarely described in CT scans as radiologists are not used to report findings of the AW as well as to know what information is really needed. For these reasons, we gathered a group of surgeons and radiologists to establish which information about the AW is important in a CT. Finally, a structured report is proposed to facilitate the description of the findings and their interpretation.
腹壁（AW）疝是普通外科医生面临的常见问题。基于临床诊断，腹疝被认为是一种简单的修复问题。然而，对患者的长期随访表明，在并发症和复发方面，结果并不理想。在这种情况下，术前规划，包括控制合并症以及全面了解疝及其与 AW 的解剖关系，已受到越来越多的关注。计算机断层扫描（CT）似乎是确定腹壁疝的确切大小和位置、是否存在腹直肌分离和/或相关的肌肉萎缩，以及疝与 AW 本身的比例的最佳选择。这些信息可能有助于外科医生选择最佳的手术技术（开放手术与微创）、网片的定位和固定，以及最终是否需要应用肉毒毒素、术前气腹或组件分离技术。尽管这些发现意义重大，但在 CT 扫描中很少描述，因为放射科医生不习惯报告 AW 的发现，也不知道真正需要哪些信息。出于这些原因，我们汇集了一组外科医生和放射科医生，以确定 CT 中关于 AW 的哪些信息是重要的。最后，提出了一份结构化报告，以方便描述发现并进行解释。
