Femoral hernia diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
Ultrasound is the diagnostic study of choice for diagnosing femoral hernia as it has low cost, widespread availability and low risk of radiation exposure. If it is an emergent case with signs of incarceration that is difficult to diagnose based on clinical examination, an abdominal CT scan must be performed to confirm the diagnosis. | [[Ultrasound]] is the diagnostic study of choice for diagnosing femoral hernia as it has low cost, widespread availability and low risk of [[radiation exposure]]. If it is an emergent case with signs of [[Incarcerated hernia|incarceration]] that is difficult to diagnose based on [[clinical examination]], an [[abdominal]] [[CT scan]] must be performed to confirm the [[diagnosis]]. | ||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Study of choice: === | === Study of choice: === | ||
*Ultrasound is the diagnostic study of choice for the diagnosis of femoral hernia.<ref name="pmid25489584">{{cite journal |vauthors=Yang XF, Liu JL |title=Acute incarcerated external abdominal hernia |journal=Ann Transl Med |volume=2 |issue=11 |pages=110 |year=2014 |pmid=25489584 |pmc=4245506 |doi=10.3978/j.issn.2305-5839.2014.11.05 |url=}}</ref> | *[[Ultrasound]] is the diagnostic study of choice for the [[diagnosis]] of femoral hernia.<ref name="pmid25489584">{{cite journal |vauthors=Yang XF, Liu JL |title=Acute incarcerated external abdominal hernia |journal=Ann Transl Med |volume=2 |issue=11 |pages=110 |year=2014 |pmid=25489584 |pmc=4245506 |doi=10.3978/j.issn.2305-5839.2014.11.05 |url=}}</ref> | ||
*If it is an emergent case and the patient presents with signs of incarceration and it is difficult to diagnose based on clinical examination, an abdominal CT scan must be performed to confirm the diagnosis.<ref name="WhalenKidd2011">{{cite journal|last1=Whalen|first1=H. R.|last2=Kidd|first2=G. A.|last3=O'Dwyer|first3=P. J.|title=Femoral hernias|journal=BMJ|volume=343|issue=dec08 1|year=2011|pages=d7668–d7668|issn=0959-8138|doi=10.1136/bmj.d7668}}</ref> | *If it is an emergent case and the patient presents with signs of [[Incarcerated hernia|incarceration]] and it is difficult to diagnose based on clinical examination, an abdominal [[CT scan]] must be performed to confirm the [[diagnosis]].<ref name="WhalenKidd2011">{{cite journal|last1=Whalen|first1=H. R.|last2=Kidd|first2=G. A.|last3=O'Dwyer|first3=P. J.|title=Femoral hernias|journal=BMJ|volume=343|issue=dec08 1|year=2011|pages=d7668–d7668|issn=0959-8138|doi=10.1136/bmj.d7668}}</ref> | ||
The sensitivity and specificity of ultrasound is as follows:<ref name="pmid12831490">{{cite journal |vauthors=Bradley M, Morgan D, Pentlow B, Roe A |title=The groin hernia - an ultrasound diagnosis? |journal=Ann R Coll Surg Engl |volume=85 |issue=3 |pages=178–80 |year=2003 |pmid=12831490 |pmc=1964363 |doi=10.1308/003588403321661334 |url=}}</ref><ref name="pmid18293054">{{cite journal |vauthors=Djuric-Stefanovic A, Saranovic D, Ivanovic A, Masulovic D, Zuvela M, Bjelovic M, Pesko P |title=The accuracy of ultrasonography in classification of groin hernias according to the criteria of the unified classification system |journal=Hernia |volume=12 |issue=4 |pages=395–400 |year=2008 |pmid=18293054 |doi=10.1007/s10029-008-0352-6 |url=}}</ref> | The [[sensitivity]] and [[specificity]] of [[ultrasound]] is as follows:<ref name="pmid12831490">{{cite journal |vauthors=Bradley M, Morgan D, Pentlow B, Roe A |title=The groin hernia - an ultrasound diagnosis? |journal=Ann R Coll Surg Engl |volume=85 |issue=3 |pages=178–80 |year=2003 |pmid=12831490 |pmc=1964363 |doi=10.1308/003588403321661334 |url=}}</ref><ref name="pmid18293054">{{cite journal |vauthors=Djuric-Stefanovic A, Saranovic D, Ivanovic A, Masulovic D, Zuvela M, Bjelovic M, Pesko P |title=The accuracy of ultrasonography in classification of groin hernias according to the criteria of the unified classification system |journal=Hernia |volume=12 |issue=4 |pages=395–400 |year=2008 |pmid=18293054 |doi=10.1007/s10029-008-0352-6 |url=}}</ref> | ||
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[[File:Femoral-hernia-2.jpg|300px|thumb|center|'''Femoral hernia'''<br>'''[https://radiopaedia.org/cases/10124 Source: radiopaedia.org, Case courtesy of Dr Maulik S Patel >rID: 10124]''']] | |||
===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
*Findings on an ultrasound suggestive of femoral hernia include:<ref name="pmid25489584">{{cite journal |vauthors=Yang XF, Liu JL |title=Acute incarcerated external abdominal hernia |journal=Ann Transl Med |volume=2 |issue=11 |pages=110 |year=2014 |pmid=25489584 |pmc=4245506 |doi=10.3978/j.issn.2305-5839.2014.11.05 |url=}}</ref> | *Findings on an [[ultrasound]] suggestive of femoral hernia include:<ref name="pmid25489584">{{cite journal |vauthors=Yang XF, Liu JL |title=Acute incarcerated external abdominal hernia |journal=Ann Transl Med |volume=2 |issue=11 |pages=110 |year=2014 |pmid=25489584 |pmc=4245506 |doi=10.3978/j.issn.2305-5839.2014.11.05 |url=}}</ref> | ||
**Expansion of the [[intestines]] with reverse [[peristalsis]] | **Expansion of the [[intestines]] with reverse [[peristalsis]] | ||
**Fixed masses without [[peristalsis]] | **Fixed masses without [[peristalsis]] | ||
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*Color [[doppler ultrasound]] may be helpful in the diagnosis of complications of femoral hernia; incarceration by observing the [[blood]] supply in the contents of the [[hernia]] sac.<ref name="pmid25489584">{{cite journal |vauthors=Yang XF, Liu JL |title=Acute incarcerated external abdominal hernia |journal=Ann Transl Med |volume=2 |issue=11 |pages=110 |year=2014 |pmid=25489584 |pmc=4245506 |doi=10.3978/j.issn.2305-5839.2014.11.05 |url=}}</ref> | *Color [[doppler ultrasound]] may be helpful in the diagnosis of complications of femoral hernia; incarceration by observing the [[blood]] supply in the contents of the [[hernia]] sac.<ref name="pmid25489584">{{cite journal |vauthors=Yang XF, Liu JL |title=Acute incarcerated external abdominal hernia |journal=Ann Transl Med |volume=2 |issue=11 |pages=110 |year=2014 |pmid=25489584 |pmc=4245506 |doi=10.3978/j.issn.2305-5839.2014.11.05 |url=}}</ref> | ||
===== Sequence of | ===== Sequence of diagnostic studies ===== | ||
The ultrasound should be performed when:<ref name="WhalenKidd2011">{{cite journal|last1=Whalen|first1=H. R.|last2=Kidd|first2=G. A.|last3=O'Dwyer|first3=P. J.|title=Femoral hernias|journal=BMJ|volume=343|issue=dec08 1|year=2011|pages=d7668–d7668|issn=0959-8138|doi=10.1136/bmj.d7668}}</ref> | The [[ultrasound]] should be performed when:<ref name="WhalenKidd2011">{{cite journal|last1=Whalen|first1=H. R.|last2=Kidd|first2=G. A.|last3=O'Dwyer|first3=P. J.|title=Femoral hernias|journal=BMJ|volume=343|issue=dec08 1|year=2011|pages=d7668–d7668|issn=0959-8138|doi=10.1136/bmj.d7668}}</ref> | ||
* The patient presented with swelling or lump in the upper thigh as the first step of diagnosis. | * The patient presented with [[swelling]] or [[lump]] in the upper [[thigh]] as the first step of [[diagnosis]]. | ||
* If it is an emergent case with signs of incarceration, abdominal CT scan can be performed to confirm the diagnosis. | * If it is an emergent case with signs of incarceration, abdominal [[CT scan]] can be performed to confirm the diagnosis. | ||
==References== | ==References== | ||
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Latest revision as of 16:20, 15 February 2018
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Femoral hernia diagnostic study of choice On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]
Overview
Ultrasound is the diagnostic study of choice for diagnosing femoral hernia as it has low cost, widespread availability and low risk of radiation exposure. If it is an emergent case with signs of incarceration that is difficult to diagnose based on clinical examination, an abdominal CT scan must be performed to confirm the diagnosis.
Diagnostic Study of Choice
Study of choice:
- Ultrasound is the diagnostic study of choice for the diagnosis of femoral hernia.[1]
- If it is an emergent case and the patient presents with signs of incarceration and it is difficult to diagnose based on clinical examination, an abdominal CT scan must be performed to confirm the diagnosis.[2]
The sensitivity and specificity of ultrasound is as follows:[3][4]
| Sensitivity | Specificity | |
|---|---|---|
| Ultrasound | 100% | 100% |
Source: radiopaedia.org, Case courtesy of Dr Maulik S Patel >rID: 10124
Diagnostic results
- Findings on an ultrasound suggestive of femoral hernia include:[1]
- Expansion of the intestines with reverse peristalsis
- Fixed masses without peristalsis
- Expansion of a fluid filled bowel
- Intestinal fluid reflux
- Thickening and edema of the intestinal wall
- Slightly echogenic, long strip shaped omentum in the hernia sac
- Color doppler ultrasound may be helpful in the diagnosis of complications of femoral hernia; incarceration by observing the blood supply in the contents of the hernia sac.[1]
Sequence of diagnostic studies
The ultrasound should be performed when:[2]
- The patient presented with swelling or lump in the upper thigh as the first step of diagnosis.
- If it is an emergent case with signs of incarceration, abdominal CT scan can be performed to confirm the diagnosis.
References
- ↑ 1.0 1.1 1.2 Yang XF, Liu JL (2014). "Acute incarcerated external abdominal hernia". Ann Transl Med. 2 (11): 110. doi:10.3978/j.issn.2305-5839.2014.11.05. PMC 4245506. PMID 25489584.
- ↑ 2.0 2.1 Whalen, H. R.; Kidd, G. A.; O'Dwyer, P. J. (2011). "Femoral hernias". BMJ. 343 (dec08 1): d7668–d7668. doi:10.1136/bmj.d7668. ISSN 0959-8138.
- ↑ Bradley M, Morgan D, Pentlow B, Roe A (2003). "The groin hernia - an ultrasound diagnosis?". Ann R Coll Surg Engl. 85 (3): 178–80. doi:10.1308/003588403321661334. PMC 1964363. PMID 12831490.
- ↑ Djuric-Stefanovic A, Saranovic D, Ivanovic A, Masulovic D, Zuvela M, Bjelovic M, Pesko P (2008). "The accuracy of ultrasonography in classification of groin hernias according to the criteria of the unified classification system". Hernia. 12 (4): 395–400. doi:10.1007/s10029-008-0352-6. PMID 18293054.
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