R. Kervancioglu et al., Ultrasonographic evaluation of bilateral groins in children with unilateral inguinal hernia, ACT RADIOL, 41(6), 2000, pp. 653-657
Purpose: The presence of hernia was investigated prospectively by US in bot
h groins of children with clinically suspected or apparent unilateral ingui
nal hernia.
Material and Methods: One hundred and twenty-eight (103 boys, 25 girls) wer
e classified into three groups according to age: 0-2, 3-5 and 6-15 years. T
he widest diameter of the inguinal canal was measured in the longitudinal p
lane while the children were in the supine position and at rest. The patent
processus vaginalis (PPV) values of 4 mm and higher were accepted as herni
a. The groins diagnosed clinically and/or ultrasonographically as hernia we
re explored surgically. The clinical and US findings were compared with sur
gical results. The relations between hernia diameters and the age groups, s
ex, right/left and inguinal/scrotal hernias were analyzed statistically.
Results: Tn 128 children, 138 groins were treated with surgery One hundred
and eleven cases were unilateral hernia (73 right, 38 left) and 10 were bil
ateral. Seven cases were found to be normal. Ten cases with clinically unil
ateral hernia were bilateral at US and surgery. One hundred and thirty-one
of 138 groins were correctly diagnosed by US. The accuracy, specificity and
sensitivity of US were 94.9%, 85.7% and 95.4%, respectively. The accuracy
of physical examination was 87.7%. There were no significant differences be
tween hernia diameters and the age groups, sex and right/left side except t
he difference between inguinal and scrotal hernia diameters (p<0.0001).
Conclusion: US can be used routinely in the pre-operative diagnosis of ingu
inal hernia in children. PPV values higher than 4 mm, with a high accuracy
indicate hernia.