Accuracy of the ultrasound examination in patients with inguinal hernia

Rev Col Bras Cir. 2019 May 9;46(2):e2108. doi: 10.1590/0100-6991e-20192108.
[Article in Portuguese, English]

Abstract

Objective: to evaluate the accuracy of ultrasonography in the diagnosis of inguinal hernia in the preoperative period of patients submitted to inguinal herniorrhaphy.

Methods: we conducted a retrospective, descriptive, analytical study, based on data obtained from the charts of patients submitted to inguinal herniorrhaphy between January 2016 and December 2017 and who underwent ultrasonography in the preoperative period. The sample consisted of 232 patients, and we compared the results of the ultrasonography with the complaints, physical examination and intraoperative findings.

Results: ultrasonography was in agreement with inguinal hernia complaint in 52% of patients (p=0.019). There was a disagreement between the percentage of patients who presented a hernia at the physical examination not confirmed by the ultrasound examination (28.57%) and the percentage of hernias identified only by the complementary examination (8.93%), with statistical significance (p=0.0291). When comparing the ultrasound findings with the intraoperative ones, 32.70% of patients presenting with hernia had normal ultrasonography, with statistical significance for discordance (p=0.001).

Conclusion: ultrasound was an unreliable method to help diagnosis in dubious cases of inguinal hernia, and dispensable when the diagnosis was confirmed by typical complaints and compatible physical examination.

Objetivo: avaliar a acurácia da ultrassonografia no diagnóstico de hérnia inguinal no pré-operatório de pacientes submetidos à herniorrafia inguinal.

Métodos: estudo retrospectivo descritivo, analítico, baseado em dados obtidos dos prontuários de pacientes submetidos à herniorrafia inguinal entre janeiro de 2016 e dezembro de 2017 e que realizaram ultrassonografia no período pré-operatório. A amostra foi composta por 232 pacientes e foram comparados os resultados da ultrassonografia com as queixas, exame físico e achados intraoperatórios desses pacientes.

Resultados: a ultrassonografia apresentou concordância com a queixa de hérnia inguinal em 52% dos pacientes (p=0,019). Houve discordância entre a porcentagem de pacientes que apresentaram hérnia ao exame físico não confirmada pelo exame ultrassonográfico (28,57%) e a porcentagem de hérnias identificadas somente ao exame complementar (8,93%), com significância estatística (p=0,0291). Quando comparados os resultados ultrassonográficos com achados intraoperatórios, 32,70% dos pacientes que apresentavam hérnia tinham ultrassonografia normal com significância estatística para discordância (p=0,001).

Conclusão: a ultrassonografia mostrou-se método não confiável para auxiliar no diagnóstico em casos duvidosos de hérnia inguinal e dispensável quando o diagnóstico era confirmado por queixas típicas e exame físico compatível.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diagnostic Self Evaluation
  • Female
  • Hernia, Inguinal / diagnostic imaging*
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Preoperative Period
  • Reference Standards
  • Reproducibility of Results
  • Retrospective Studies
  • Ultrasonography / standards*
  • Young Adult