Ultrasonography of inguinal hernia - Revision history

Mikael Häggström: /* Further workup if not detected */ Emphasis

2019-07-14T13:51:54Z

Further workup if not detected: Emphasis

Mikael Häggström: /* Evaluation */ Corrected

2019-04-15T10:02:34Z

Evaluation: Corrected

Mikael Häggström: Indirect

2019-04-11T09:26:54Z

Indirect

Mikael Häggström: /* How soon */ Wording

2019-04-11T09:20:40Z

How soon: Wording

Mikael Häggström: Templated

2019-04-11T09:20:17Z

Templated

Mikael Häggström: Templated

2019-04-11T09:18:26Z

Templated

Mikael Häggström: /* Evaluation */ + Normal

2019-04-11T09:10:26Z

Evaluation: + Normal

Mikael Häggström: Templated

2019-04-11T06:05:11Z

Templated

Mikael Häggström: /* Further workup if not detected */ same session

2019-01-10T10:23:12Z

Further workup if not detected: same session

Mikael Häggström: If not detected

2019-01-10T10:21:03Z

If not detected

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 If the hernia is not clearly within the inguinal canal, check if it lies medially to the inferior epigastric vessels, since it is then classified as a ''direct hernia''.
-===Further workup if not detected===
+===Further workup if NOT detected===
 If the pain location may suggest it, also consider performing an '''[[Ultrasonography of femoral hernia]]''' and/or '''[[Ultrasonography of hydronephrosis]]''' in the same session.
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@@ Line 13: / Line 13: @@
 ==Evaluation==
 [[File:Ultrasonography of inguinal hernia (annotated).jpg|thumb|300px|Ultrasound of an indirect hernia containing fat, with testicle seen at right.]]
-Without and with Valsalva maneuver.<ref name="JamadarJacobson2006">{{cite journal|last1=Jamadar|first1=David A.|last2=Jacobson|first2=Jon A.|last3=Morag|first3=Yoav|last4=Girish|first4=Gandikota|last5=Ebrahim|first5=Farhad|last6=Gest|first6=Thomas|last7=Franz|first7=Michael|title=Sonography of Inguinal Region Hernias|journal=American Journal of Roentgenology|volume=187|issue=1|year=2006|pages=185–190|issn=0361-803X|doi=10.2214/AJR.05.1813}}</ref> Preferably also in standing.<ref name="JamadarJacobson2006"/> Look primarily for an increased diameter of the inguinal canal, which is normally up to 13 mm at the deep inguinal ring.<ref name="KumarPatel 2018">{{cite journal|last1=Kumar|first1=Vipin|last2=Patel |first2=Jignesh |last3=Sharma |first3=Chakraprabha |last4=Inkhiya |first4=Suman |title=Morphometric Study of Inguinal Canal on Cadaver|journal=International Journal of Anatomy and Research|volume=6|issue=2.1|year=2018|pages=5172–5175|issn=23218967|doi=10.16965/ijar.2018.147}}</ref>
+Without and with Valsalva maneuver.<ref name="JamadarJacobson2006">{{cite journal|last1=Jamadar|first1=David A.|last2=Jacobson|first2=Jon A.|last3=Morag|first3=Yoav|last4=Girish|first4=Gandikota|last5=Ebrahim|first5=Farhad|last6=Gest|first6=Thomas|last7=Franz|first7=Michael|title=Sonography of Inguinal Region Hernias|journal=American Journal of Roentgenology|volume=187|issue=1|year=2006|pages=185–190|issn=0361-803X|doi=10.2214/AJR.05.1813}}</ref> Preferably also in standing.<ref name="JamadarJacobson2006"/> Look primarily for an increased diameter of the inguinal canal, which is normally 2 cm (±1 cm in standard deviation) at the deep inguinal ring.<ref group="notes">±2.2cm ±1.08cm in Africans, and 2.1 cm 0.41 ±0.58cm in Europeans.</ref><ref name="MituraKozieł2018">{{cite journal|last1=Mitura|first1=Kryspin|last2=Kozieł|first2=Sławomir|last3=Pasierbek|first3=Michał|title=Ethnicity-related differences in inguinal canal dimensions between African and Caucasian populations and their potential impact on the mesh size for open and laparoscopic groin hernia repair in low-resource countries in Africa|journal=Videosurgery and Other Miniinvasive Techniques|volume=13|issue=1|year=2018|pages=74–81|issn=1895-4588|doi=10.5114/wiitm.2018.72579}}</ref>
 ===Further workup if detected===

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 |author2=
 }}
 ==Planning==
 {{Inguinal hernia - indication and choice of modality}}

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 ===How soon===
-In Swedish practice, an inguinal bulge is evaluated within 2 months unless there is significant pain.<ref group=notes>{{NU Hospital Group}}</ref>
+In Swedish practice, ultrasonography of an inguinal bulge is performed within 2 months unless there is significant pain.<ref group=notes>{{NU Hospital Group}}</ref>
 ==Evaluation==

@@ Line 4: / Line 4: @@
 }}
 ==Planning==
-In Swedish practice, an inguinal bulge is evaluated within 2 months unless there's significant pain.<ref group=notes>{{NU Hospital Group}}</ref>
+{{Inguinal hernia - indication and choice of modality}}
-{{Inguinal hernia - indication and choice of modality}}
+===How soon===
 ==Evaluation==

@@ Line 6: / Line 6: @@
 In Swedish practice, an inguinal bulge is evaluated within 2 months unless there's significant pain.<ref group=notes>{{NU Hospital Group}}</ref>
-In strong '''[[abdominal pain]]''', a suspected strangulated hernia indicates surgery without previous ultrasound, whereas an unclear diagnosis indicates '''[[abdominal CT]]'''.
+{{Inguinal hernia - choice of modality}}
 ==Evaluation==

@@ Line 12: / Line 12: @@
 Without and with Valsalva maneuver.<ref name="JamadarJacobson2006">{{cite journal|last1=Jamadar|first1=David A.|last2=Jacobson|first2=Jon A.|last3=Morag|first3=Yoav|last4=Girish|first4=Gandikota|last5=Ebrahim|first5=Farhad|last6=Gest|first6=Thomas|last7=Franz|first7=Michael|title=Sonography of Inguinal Region Hernias|journal=American Journal of Roentgenology|volume=187|issue=1|year=2006|pages=185–190|issn=0361-803X|doi=10.2214/AJR.05.1813}}</ref> Preferably also in standing.<ref name="JamadarJacobson2006"/>
-===Further workup===
+===Further workup if detected===
 If an inguinal hernia is detected:
 *'''Size''' with and without provocation (Valsalva maneuver and/or standing)
@@ Line 18: / Line 18: @@
 *Ability to '''reduce''' by pressure
 If the hernia is not clearly within the inguinal canal, check if it lies medially to the inferior epigastric vessels, since it is then classified as a ''direct hernia''.
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