Femoral hernia diagnostic study of choice
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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
Diagnostic Study of Choice
=== Study of choice: ===[1]
- Ultrasound is the diagnostic study of choice for the diagnosis of femoral hernia.
- The [name of the investigation] should be performed when:
- The patient presented with symptoms/signs 1. 2, 3.
- A positive [test] is detected in the patient.
- [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
- The diagnostic study of choice for [disease name] is [name of the investigation].
- There is no single diagnostic study of choice for the diagnosis of [disease name].
- There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
- Femoral hernia mainly diagnosed based on clinical presentation.
- Investigations:
- Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
- Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
- Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
The sensitivity and specificity of ultrasound is as follows:[2][3]
| Sensitivity | Specificity | |
|---|---|---|
| Ultrasound | 100% | 100% |
Diagnostic results
- Findings on an ultrasound suggestive of femoral hernia include:[4]
- 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.[4]
Sequence of Diagnostic Studies
The ultrasound should be performed when:[1]
- 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 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.
- ↑ 4.0 4.1 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.