Journal of Ultrasound in Medicine, Vol 18, Issue 8 565-568, Copyright © 1999 by American Institute of Ultrasound in Medicine
Color duplex sonography: diagnostic tool in the differentiation of inguinal hernias
M. Korenkov, A. Paul and H. Troidl
II Department of Surgery, University of Cologne, Germany.
We investigated the accuracy of combined physical and color duplex
sonographic examination in the preoperative distinction of direct inguinal
hernias. After a learning period (with 15 male patients) 50 consecutive
male patients who underwent surgery in our department for small inguinal
hernias between July 1995 and April 1996 were examined. On color duplex
examination the relationship between the hernial sac and the inferior
epigastric artery was determined. Intraoperative results were then compared
with the data obtained preoperatively. The sensitivity of our physical
examination for direct inguinal hernia was 75% with a specificity and a
positive predictive value of 100% and a negative predictive value of 80%.
The identification of the IEA as well as the hernial sac was successful on
every color duplex sonographic study. The sensitivity of color duplex
sonography for direct inguinal hernias amounted to 90%, the specificity was
86%, the positive predictive value was 78%, and the negative predictive
value was 89%. Both combined hernias found intraoperatively had not been
detected either by physical examination or by color duplex examination.
Correspondence of results obtained by physical examination and color duplex
examination leads to high accuracy in the diagnosis of direct inguinal
hernias.