Complications after herniography in adults.

Positive contrast herniography has been used in adult patients with unexplained groin pain for the detection of clinically occult inguinal hernias. Herniography involves puncture of the anterior abdominal wall and injection of an iodine contrast medium. Complications may be encountered from either phase of the procedure and were recorded in 19 (5.8%) of 330 herniographies. Difficulties in puncturing the abdominal wall as well as in injecting the contrast medium were noted in 12 (3.6%); these difficulties included injection into the stomach (one patient), left iliac vein (one patient), colon (three patients), and anterior abdominal wall (four patients). In three patients a painful hematoma developed at the site of puncture. Adverse reaction to the injection of contrast medium (80 ml meglumine metrizoate, 200 mg l/ml) was noted in seven (2.1%) patients. Five of these had a vasovagal reaction and two developed severe abdominal pain within a few hours after the examination. They were hospitalized for 24 hr due to suspected peritonitis. When 52 consecutive patients were asked about pain during or after the injection of contrast medium, 15% described severe pain while 23% admitted moderate pain. As in other invasive examinations, herniography involves a certain risk. This study shows that complications occur with the same or lower frequency than in urography.