Purpose: Role of herniography in patients with unexplained pain and/or clinically doubtful hernia of the abdominal wall, especially after previous operation (for hernia). Patient tolerance and side effects of herniography.
Material and methods: After puncture of the linea alba caudal of the umbilicus water soluble low osmolar contrast medium is injected into the peritoneal cavity. 8 radiographs of the inguinal region are taken. In order to visualize umbilical and cicatricial hernias tangential projections of the anterior abdominal wall are taken in ventral decubitus. In 67 Patients herniography was performed with the following indications: groin pain in 47, groin swelling or anterior abdominal wall swelling in 7, pain in the groin combined with swelling or other indications in 6, other indications in 12. 20 Patients had previously been operated for an inguinal hernia. In order to evaluate possible side effects 57 patients filled out a questionnaire.
Results: 66 herniographies were performed successfully. In 31 Patients a total of 51 hernias was found: 18 indirect, 21 direct inguinal hernias, 1 femoral hernia, 4 umbilical hernias, 1 epigastric and 6 incisional hernias. In the group with recurrent hernias, direct inguinal hernias predominated. Subsequently 12 patients were operated. In 11 cases the presence and type of the radiologically diagnosed hernias was confirmed. 1 Patient had a false negative result. No serious side effects were noted. 9 Patients had slight abdominal discomfort during or shortly after the examination. One patient with a persistent open tunica vaginalis testis experienced painless scrotal swelling.
Conclusion: Hernias of the abdominal wall can be well demonstrated and classified by herniography with little side effects.