Patients with stoma, fistula, and/or abdominal wall infection were excluded [25]. US Pelvis There is no relevant literature regarding the use of US pelvis in the evaluation of abdominal wall hernia. Variant 2: Suspected groin hernia such as inguinal or femoral. Initial imaging. Inguinal hernias are common entities. Clinical diagnosis and differentiation of direct inguinal, indirect inguinal, and femoral hernias may be difficult. These hernias present in similar fashion with bulge, pain, and potentially signs and symptoms of bowel obstruction. In addition, the hernia may be occult, presenting with groin or pelvic pain in the absence of a palpable bulge or any other typical clinical examination findings. They may also present as an Hernia incidental finding in patients with athletic pub algia or chronic pain following herniorrh aphy [2 6,27]. Imag ing techniques p rovide visualization of the key anatomic landmarks and the relative position of herniated tissues, allowing differentiation of these entities. In addition, the impact of herniated tissues on the adjacent structures such as compression of the femoral vein in femoral hernia may be identified, aiding specific diagnosis [28]. CT Pelvis In a single prospective study, specifically evaluating CT imaging limited to the lower abdomen and pelvis evaluated prone patient positioning for hernia specific CT, there were 914 patients included in this prospective study and surgery was the reference standard. A prone CT protocol yielded an accuracy rate of 95.8% [33]. There are no specific data regarding the use of CT without and with IV contrast, but theoretically, the additional information gained between comparison of a noncontrast and postcontrast series would not be beneficial for hernia detection and characterization. Fluoroscopy Small Bowel Follow-Through There is no relevant literature regarding the use of fluoroscopy small bowel follow-through in the evaluation of groin, inguinal, or femoral hernia.
Hernia. Patients with stoma, fistula, and/or abdominal wall infection were excluded [25]. US Pelvis There is no relevant literature regarding the use of US pelvis in the evaluation of abdominal wall hernia. Variant 2: Suspected groin hernia such as inguinal or femoral. Initial imaging. Inguinal hernias are common entities. Clinical diagnosis and differentiation of direct inguinal, indirect inguinal, and femoral hernias may be difficult. These hernias present in similar fashion with bulge, pain, and potentially signs and symptoms of bowel obstruction. In addition, the hernia may be occult, presenting with groin or pelvic pain in the absence of a palpable bulge or any other typical clinical examination findings. They may also present as an Hernia incidental finding in patients with athletic pub algia or chronic pain following herniorrh aphy [2 6,27]. Imag ing techniques p rovide visualization of the key anatomic landmarks and the relative position of herniated tissues, allowing differentiation of these entities. In addition, the impact of herniated tissues on the adjacent structures such as compression of the femoral vein in femoral hernia may be identified, aiding specific diagnosis [28]. CT Pelvis In a single prospective study, specifically evaluating CT imaging limited to the lower abdomen and pelvis evaluated prone patient positioning for hernia specific CT, there were 914 patients included in this prospective study and surgery was the reference standard. A prone CT protocol yielded an accuracy rate of 95.8% [33]. There are no specific data regarding the use of CT without and with IV contrast, but theoretically, the additional information gained between comparison of a noncontrast and postcontrast series would not be beneficial for hernia detection and characterization. Fluoroscopy Small Bowel Follow-Through There is no relevant literature regarding the use of fluoroscopy small bowel follow-through in the evaluation of groin, inguinal, or femoral hernia.