Preoperative barium contrast enema in patients with inguinal hernia.

Whether patients over age 40 should have a barium contrast enema (BCE) examination for possible identification of an unsuspected colon carcinoma before elective inguinal herniorrhaphy remains an unanswered question. We reviewed the medical records of all patients over age 40 who had inguinal herniorrhaphy at our institution between January 1980 and December 1984. Of 80 patients, 46 received a preoperative barium enema. One asymptomatic colon carcinoma (2.1%) was discovered. The reported incidence of asymptomatic colon cancer found by BCE in association with inguinal hernia ranges from 0 to 2.5%. We conclude that if there is a cause and effect relationship between asymptomatic colon cancer and inguinal hernia, the mechanism is as yet unknown.