Groin hernias in adults: Value of color Doppler sonography in their classification

Purpose. We assessed the abilities of color Doppler and power Doppler sonog raph, distinguish among types of groin hernias by demonstrating the inferio r epigastric artery (IEA) and its relationship with the hernia sac. Methods. Nineteen consecutive patients (14 men and 5 women), clinically dia gnosed as having groin hernias and scheduled to undergo herniorrhaphy, were prospectively enrolled in this study. Ultrasound examinations were perform ed preoperatively with a 6-12-MHz linear-array transducer. The IEA was iden tified, if possible, and its relationship to the hernia sac assessed. The s onographic diagnoses were compared with the operative findings. Results. There were 15 indirect inguinal hernias, 4 direct inguinal hernias , and 1 femoral hernia; 1 patient had bilateral inguinal hernias (indirect and direct). In 18 (90%) of 20 hernia cases, the trunk segment of the IEA c ould be visualized. In 11 (55%) of 20 hernia cases, the origin segment of t he IEA could be visualized and its relationship with the hernia sac assesse d. In 9 (82%) of the 11 hernia cases, hernia types were correctly diagnosed by sonography. The overall accuracy of sonography for diagnosing the type of hernia was 45% (9 of 20 hernias). Conclusions. Color Doppler sonography can accurately differentiate types of groin hernias if the origin segment of the IEA and the hernia sac can be v isualized simultaneously. However, color Doppler sonography sometimes faile d to visualize this segment (C) 2001 John Wiley & Sons, Inc.