Impact of Pelvic Bone Anatomy on Inguinal Hernia and the Role of Radiological Pelvimetry

Akash Rajeev; Ashwin Vinod; George M John; Pradeep Jacob; Riju Ramachandran; Vishal Marwaha

doi:10.7759/cureus.21269

Impact of Pelvic Bone Anatomy on Inguinal Hernia and the Role of Radiological Pelvimetry

Cureus. 2022 Jan 15;14(1):e21269. doi: 10.7759/cureus.21269. eCollection 2022 Jan.

Authors

Akash Rajeev¹, Ashwin Vinod¹, George M John¹, Pradeep Jacob¹, Riju Ramachandran¹, Vishal Marwaha²

Affiliations

¹ General Surgery, Amrita Institute of Medical Sciences and Hospital, Kochi, IND.
² Rheumatology, Amrita Institute of Medical Sciences and Hospital, Kochi, IND.

Abstract

Introduction One of the most prevalent disorders treated by general surgeons is inguinal hernias. Many of the etiological factors that lead to hernia development are unknown. This study looked at the role of pelvic bone anatomy in the development of inguinal hernia. The pubic tubercle's location (as measured by the Radoievitch angle) and its relationship to the formation of inguinal hernia, as well as its function in the pathophysiology of various forms of inguinal hernia, were investigated. Materials and methods From October 2019 to June 2021, a prospective case-control study with 70 individuals over the age of 18 years in each arm was conducted in the Department of General Surgery at our tertiary care institution. Plain digital X-ray radiography of the pelvis, including bilateral hips, was taken in the anteroposterior (AP) view with the patient in the supine position, and the Radoievitch angle and Ami line were measured using suitable measuring instruments. The required information for patients in both groups was tallied and examined in a data sheet. Results Between the case and control groups, there was a statistically significant difference in the mean Radoievitch angles and the mean length of the Ami line (42.46 +/-2.442 degrees vs 40.91 +/-2.547 degrees; p<0.05); (8.54+/-1.059 cm vs 7.27+/-1.034 cm; p<0.05). There was a statistically significant increase in the Radoievitch angle of patients with bilateral hernias compared to unilateral hernias (p-value <0.01), as well as indirect hernias compared to other forms of hernias (p-value <0.05). Conclusion The probability of having an inguinal hernia was higher when the Fruchaud region was increased, as indicated by a larger Radoievitch angle or a longer Ami line. A low-lying pubic tubercle increased the likelihood of bilateral and indirect inguinal hernias. Pelvimetry is an easy test that should be considered on a routine basis and can be applied accurately in all patients. Surgeons can employ pelvimetry to identify patients who are more likely to benefit from non-mesh repairs.

Keywords: groin hernia; inguinal hernia repair; pelvic anatomy; pelvimetry; x-ray pelvis.