From the Guidelines
Ultrasound is the recommended initial imaging modality for diagnosing right inguinal hernia due to its high sensitivity and specificity, non-invasive nature, and lack of radiation exposure. When performing the ultrasound examination, a high-frequency linear transducer (7-12 MHz) should be used with the patient in both supine and standing positions, as well as during Valsalva maneuver to increase intra-abdominal pressure 1. The sonographer should scan the inguinal region systematically, identifying key landmarks including the inferior epigastric vessels, inguinal ligament, and pubic tubercle to determine if the hernia is direct or indirect. Some key benefits of using ultrasound for diagnosing right inguinal hernia include:
- Non-invasive nature
- Lack of radiation exposure
- Real-time dynamic assessment
- Relatively inexpensive compared to CT or MRI
- Ability to visualize hernia contents (bowel, fat, or fluid)
- Ability to assess for incarceration or strangulation
- Ability to measure the size of the hernia defect According to the study by Hung et al, as referenced in 1, the overall sensitivity and specificity of ultrasound in assessing soft-tissue masses were 94.1% and 99.7%, respectively, highlighting the accuracy of ultrasound in diagnosing superficial masses. However, it is essential to remember that when ultrasound imaging or clinical features are atypical, further imaging may be required 1.
From the Research
Diagnosis of Right Inguinal Hernia
- The diagnosis of inguinal hernias can usually be made through history and physical examination 2, 3.
- Ultrasonography (US) may be helpful in diagnosing a hernia in certain cases, such as:
Use of Ultrasonography for Right Inguinal Hernia
- US is a useful diagnostic tool for inguinal hernias, especially in cases where physical examination is unclear or inconclusive 2, 3.
- US can help diagnose occult hernias if clinical suspicion is high despite negative physical examination findings 3.
- Magnetic resonance imaging (MRI) may be used if US findings are negative but clinical suspicion remains high, as it has higher sensitivity and specificity than US 3.
Surgical Repair of Inguinal Hernias
- Laparoscopic repair is associated with shorter recovery time, earlier resumption of activities of daily living, less pain, and lower recurrence rates than open repair 3, 4, 5, 6.
- The choice of surgical technique (open or laparoscopic) depends on various factors, including the patient's symptoms, the size and type of hernia, and the surgeon's experience and preference 4, 6.