Anatomical differentiation of direct and indirect inguinal hernias: Is it worthwhile in the modern era?

Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
P SanjayA Woodward

Abstract

The study aimed to assess the clinical accuracy of differentiating direct and indirect inguinal hernias preoperatively by different grades of surgeons. A retrospective audit was conducted over a 9-year period and comprised all adult inguinal hernia patients operated by one consultant surgeon. The hernias were differentiated into direct and indirect hernias based on the direction of cough impulse and the deep ring occlusion test. The preoperative diagnosis was compared with intraoperative findings. During the study period, 503 patients were examined. Of these, 272 patients were diagnosed as having indirect hernias and 56 patients as having direct hernias. In 175 patients, no attempt was made to differentiate indirect and direct hernias. When compared with intraoperative findings, the diagnosis was correct in 77% of the indirect hernias and 55% of direct hernias. Of the patients in whom no differentiation was attempted, 115 patients had indirect hernias, 56 had direct hernias, and four had both. For indirect hernias, the diagnostic accuracy was 82, 63, and 30% for consultant, registrars, and senior house officers. For direct hernias, the diagnostic accuracy was 66, 50, and 44%, respectively. This study demonstrates relatively poo...Continue Reading

References

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Apr 26, 2006·Surgical and Radiologic Anatomy : SRA·P SanjayA Woodward

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Citations

May 28, 2013·Surgical Endoscopy·M M PoelmanH J Bonjer
Jan 9, 2014·Surgical Endoscopy·Wouter G TrompBoudewijn J Dwars
Sep 11, 2010·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Samuel J M HaleMark D Stringer
Jan 11, 2014·Hernia : the Journal of Hernias and Abdominal Wall Surgery·B KimR Achuthan
Apr 13, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Matthew J KraeutlerAnthony J Scillia

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