From the Research
Ultrasound is the preferred initial imaging modality for evaluating umbilical hernias. It is non-invasive, does not use radiation, and can effectively visualize the hernia sac, its contents, and determine if the hernia is reducible or incarcerated 1. For more complex cases or when complications are suspected, CT scanning provides superior anatomical detail and can identify strangulation, bowel obstruction, or other intra-abdominal pathologies that may be associated with the hernia.
Key Points to Consider
- Ultrasound is a reliable method for confirming the presence of groin hernias and identifying specific ultrasound findings predictive of complications, such as aperistaltic nonreducible bowel loops, free fluid in the hernia sac, and lack of color doppler in the entrapped mesentery and bowel walls 1.
- Imaging is often unnecessary for diagnosis of umbilical hernias in most patients, as they can typically be diagnosed through clinical examination alone.
- The physical finding of a protruding mass at the umbilicus that increases with Valsalva maneuver and may be reducible is usually sufficient for diagnosis.
- Imaging becomes more important when evaluating for complications or planning surgical intervention, especially in adults with obesity or when the clinical presentation is atypical.
Additional Considerations
- MRI may occasionally be used in specific situations where soft tissue detail is crucial, particularly in obese patients or when ultrasound findings are inconclusive.
- The use of a mesh in umbilical hernia repair is subject to debate, particularly for small (< 2 cm) umbilical hernias 2.
- Patient factors, including patient age and sex, had no impact on operative approach or use of mesh in umbilical hernia repair 3.