Color Doppler sonography for ventral hernias in patients with acute abdomen: Preliminary findings

Purpose. We assessed the usefulness of color Doppler sonography (CDUS) in e valuating the vascular status of ventral hernias and distinguishing incarce rated from nonincarcerated ventral hernias. Methods. In this prospective study, 10 patients who presented with acute ab domen and had ventral hernias underwent CDUS from August 1999 to May 2000. Patient age and sex and the clinical severity, mode of therapy, and outcome in these 10 patients were evaluated in relationship to the CDUS findings. Results. Five patients had readily visible flow in the bowel within the her nial sac on CDUS. Two of these 5 had spontaneous reduction under conservati ve treatment, and 3 had asymptomatic ventral hernias with acute abdomen cau sed by spontaneous bacterial peritonitis. Barely visible flow was visualize d in the bowel by CDUS in 4 other patients. Three of these underwent emerge ncy surgery because of peritoneal signs; 2 of them were found to have ische mic changes in the bowel. The fourth patient underwent a successful manual reduction. The remaining patient had absent flow in the bowel on CDUS and u nderwent emergency surgery, which revealed gangrenous changes in the bowel. Conclusions. The intensity of the Doppler signals on CDUS appears to be a p romising predictor of bowel viability in cases of ventral hernia. Thus, CDU S should impact the determination of the treatment plan, including whether to provide conservative treatment or surgery. (C) 2001 John Wiley & Sons, I nc.