Nasir et al [47], in a retrospective review, found that patients diagnosed with obturator hernia on preoperative CT are less likely to develop postoperative complications (odds ratio: 0.8, P = . 04). Preoperative diagnosis did not impact length of stay, bowel resection, or mortality rates. CT has also been found to be efficacious in the diagnosis of sciatic and perineal hernias [51,53]. Because of the infrequency of these entities and the majority of literature being in the form of case reports, sensitivities, specificities, and accuracy ranges are not available. There are no specific data differentiating diagnostic efficacy of an IV contrast versus noncontrast examination. 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. CT Pelvis Retrospective reviews of clinical databases regarding imaging diagnosis of these rare deep pelvic hernias do not separate abdominal pelvic CT from pelvic CT alone [47,51,53]. Depending upon the area of coverage, CT pelvis can be useful in diagnosis and pre-operative planning. There are no specific data differentiating diagnostic efficacy of an IV contrast versus noncontrast examination. 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. Of note, CT without and with IV contrast is not typically performed for this scenario. Hernia Fluoroscopy Small Bowel Follow-Through There is no relevant literature regarding the use of small bowel follow-through in the evaluation of deep pelvic hernia. However, demonstration of abnormal bowel configuration suggesting herniation may be helpful in complex cases.
Hernia. Nasir et al [47], in a retrospective review, found that patients diagnosed with obturator hernia on preoperative CT are less likely to develop postoperative complications (odds ratio: 0.8, P = . 04). Preoperative diagnosis did not impact length of stay, bowel resection, or mortality rates. CT has also been found to be efficacious in the diagnosis of sciatic and perineal hernias [51,53]. Because of the infrequency of these entities and the majority of literature being in the form of case reports, sensitivities, specificities, and accuracy ranges are not available. There are no specific data differentiating diagnostic efficacy of an IV contrast versus noncontrast examination. 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. CT Pelvis Retrospective reviews of clinical databases regarding imaging diagnosis of these rare deep pelvic hernias do not separate abdominal pelvic CT from pelvic CT alone [47,51,53]. Depending upon the area of coverage, CT pelvis can be useful in diagnosis and pre-operative planning. There are no specific data differentiating diagnostic efficacy of an IV contrast versus noncontrast examination. 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. Of note, CT without and with IV contrast is not typically performed for this scenario. Hernia Fluoroscopy Small Bowel Follow-Through There is no relevant literature regarding the use of small bowel follow-through in the evaluation of deep pelvic hernia. However, demonstration of abnormal bowel configuration suggesting herniation may be helpful in complex cases.