Universidad Autonoma de Nuevo Leon, School of Medicine, Human Anatomy Department, Clinical and Surgical Research Group (GICQx), Monterrey, Nuevo Leon, Mexico.
Universidad Autonoma de Nuevo Leon, School of Medicine, Human Anatomy Department, Clinical and Surgical Research Group (GICQx), Monterrey, Nuevo Leon, Mexico.
J Surg Res. 2024 Oct;302:33-39. doi: 10.1016/j.jss.2024.07.014. Epub 2024 Jul 30.
Umbilical hernias (UHs) are commonly underdiagnosed due to their asymptomatic presentation. The aim was to determine the prevalence of UHs by computed tomography (CT) in a trauma center, to assess the magnitude of their underdiagnosis.
A cross-sectional study was designed, using CT studies to evaluate the integrity of the abdominal wall. The images were obtained from consecutive cases of adult patients (≥18 y) from the database of the radiology and imaging service during a 4-mo period. The sociodemographic features, type of CT scan, and description of the abdominal wall were obtained and compared with the radiology report. In the case of UH presence, the transversal, cephalocaudal, and anteroposterior lengths, as well as its content, were registered.
A total of 472 CT scans were included with a 67.6% (n = 319) prevalence of UH. These were most common in men (58.9%, n = 188/319), but women were more likely to have UH ≥ 10 mm (55%, n = 72/131). Of those with UH, 63.6% were unreported by radiology. The most common content was peritoneal fat (87.5%). UH had medians (interquartile range) of 9.1 mm (6.8, 12.5), 8.3 mm (6, 11.5), and 12.8 mm (8.6, 18.2) in its transversal, cephalocaudal, and anteroposterior lengths, respectively. Transversal length had a high positive correlation with cephalocaudal length (r = 0.877). This datum relationship can be explained by at least 76% due to this factor. Interobserver reliability analyses resulted in substantial reliability (ICC>0.85 and k > 0.85).
CT is an effective imaging tool for diagnosing UH. There is a high prevalence among the general adult population, with a high radiologic underreporting.
由于脐疝（UH）通常表现为无症状，因此容易漏诊。本研究旨在通过在创伤中心进行计算机断层扫描（CT），确定 UH 的患病率，并评估其漏诊程度。
设计了一项横断面研究，使用 CT 研究评估腹壁的完整性。在 4 个月的时间内，从放射科和影像服务数据库中获取连续的成年患者（≥18 岁）的 CT 图像。获取患者的社会人口统计学特征、CT 扫描类型和腹壁描述，并与放射科报告进行比较。如果存在 UH，则记录其横径、头足径和前后径以及内容物。
共纳入 472 例 CT 扫描，其中 UH 的患病率为 67.6%（n=319）。男性（58.9%，n=188/319）更常见，但女性 UH≥10mm 的可能性更高（55%，n=72/131）。在有 UH 的患者中，有 63.6%的患者未被放射科报告。最常见的内容物是腹膜脂肪（87.5%）。UH 的横径（中位数[四分位距]）、头足径（中位数[四分位距]）和前后径（中位数[四分位距]）分别为 9.1mm（6.8, 12.5）、8.3mm（6, 11.5）和 12.8mm（8.6, 18.2）。横径与头足径具有高度正相关（r=0.877）。这种数据关系至少有 76%可以用这个因素来解释。观察者间可靠性分析结果显示具有高度可靠性（ICC>0.85 和 k>0.85）。
CT 是诊断 UH 的有效影像学工具。在普通成年人群中，患病率较高，放射科漏诊率较高。
