Color duplex sonography: Diagnostic tool in the differentiation of inguinal hernias

We investigated the accuracy of combined physical and color duplex sonograp hic examination in the preoperative distinction of direct inguinal hernias. After a learning period (with 15 male patients) 50 consecutive male patien ts who underwent surgery in our department for small inguinal hernias betwe en July 1995 and April 1996 were examined. On color duplex examination the relationship between the hernial sac and the inferior epigastric artery was determined. Intraoperative results were then compared with the data obtain ed preoperatively. The sensitivity of our physical examination for direct i nguinal hernia was 75% with a specificity and a positive predictive value o f 100% and a negative predictive value of 80%. The identification of the IE A as well as the hernial sac was successful on every color duplex sonograph ic study. The sensitivity of color duplex sonography for direct inguinal he rnias amounted to 90%, the specificity was 86%, the positive predictive val ue was 78%, and the negative predictive value was 89%. Both combined hernia s found intraoperatively had not been detected either by physical examinati on or by color duplex examination. Correspondence of results obtained by ph ysical examination and color duplex examination leads to high accuracy in t he diagnosis of direct inguinal hernias.