Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina.
Department of Abdominal Wall and Reconstructive Microsurgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina.
Langenbecks Arch Surg. 2023 Oct 17;408(1):408. doi: 10.1007/s00423-023-03146-2.
It remains unclear whether ultrasound-detected hernias (UDH) are the sole cause of pain in patients with groin pain, and clinical examination plays a complementary role. The aim of our study is to describe the evolution of patients with ultrasound detected hernias in terms of development of groin hernia detected by physical examination, pain resolution, and alternative diagnosis.
An observational, descriptive, longitudinal study of a prospective case series including patients with UDH with groin pain. Follow-up evaluation included the following: follow-up time, side of pain, its evolution, time to resolution, clinical hernia (CH) development, need for surgical resolution, and the presence of postoperative pain and alternative diagnosis.
A total of 98 patients with complete follow-up for groin pain and UDH were included. Seven patients (7.1%) developed CH, with a median time to conversion of 8 months. Four of them (4.1% of the total and 57.1% of the ones who developed CH) ended up having surgery. Fifty-three patients (54.1%) resolved their pain in a median time to resolution of 2 months, and 75.5% of them did so spontaneously. The majority of patients with persistent pain (73.3%) were able to lead a normal life and only reported pain with movement. More than half of the patients (53.3%) reached a specific diagnosis. Among those patients who did not develop CH, 39.6% reached an alternative diagnosis, the majority being musculoskeletal pathologies.
Watchful waiting and a thorough search for other alternative causes of groin pain in UDH and clinically occult hernia would be a reasonable option.
目前尚不清楚超声检测到的疝气（UDH）是否是腹股沟疼痛患者疼痛的唯一原因，临床检查起着补充作用。我们研究的目的是描述经超声检测出疝的患者的演变情况，包括体格检查发现腹股沟疝、疼痛缓解和其他诊断的情况。
这是一项前瞻性病例系列的观察性、描述性、纵向研究，纳入了有腹股沟疼痛和 UDH 的患者。随访评估包括：随访时间、疼痛部位、其演变、缓解时间、临床疝（CH）发展、是否需要手术解决以及术后疼痛和其他诊断的存在。
共纳入了 98 例有完整腹股沟疼痛和 UDH 随访的患者。7 例（7.1%）患者出现 CH，转换时间中位数为 8 个月。其中 4 例（总病例的 4.1%和出现 CH 的病例的 57.1%）最终接受了手术。53 例（54.1%）患者疼痛在中位缓解时间 2 个月内缓解，其中 75.5%为自发性缓解。大多数持续性疼痛患者（73.3%）能够正常生活，仅在活动时出现疼痛。超过一半的患者（53.3%）能够得到明确的诊断。在未出现 CH 的患者中，39.6%患者有其他替代诊断，其中大多数为肌肉骨骼病变。
在 UDH 和临床隐匿性疝中，密切观察和彻底寻找腹股沟疼痛的其他替代原因可能是一种合理的选择。
