Femoral hernia diagnostic study of choice
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]
Overview
Ultrasound is the diagnostic study of choice for diagnosing femoral hernia as it has low cost, widespread availability and low risk of radiation exposure. If it is an emergent case with signs of incarceration that is difficult to diagnose based on clinical examination, an abdominal CT scan must be performed to confirm the diagnosis.
Diagnostic Study of Choice
Study of choice:
- Ultrasound is the diagnostic study of choice for the diagnosis of femoral hernia.[1]
- If it is an emergent case and the patient presents with signs of incarceration and it is difficult to diagnose based on clinical examination, an abdominal CT scan must be performed to confirm the diagnosis.[2]
The sensitivity and specificity of ultrasound is as follows:[3][4]
| Sensitivity | Specificity | |
|---|---|---|
| Ultrasound | 100% | 100% |
Source: radiopaedia.org, Case courtesy of Dr Maulik S Patel >rID: 10124
Diagnostic results
- Findings on an ultrasound suggestive of femoral hernia include:[1]
- Expansion of the intestines with reverse peristalsis
- Fixed masses without peristalsis
- Expansion of a fluid filled bowel
- Intestinal fluid reflux
- Thickening and edema of the intestinal wall
- Slightly echogenic, long strip shaped omentum in the hernia sac
- Color doppler ultrasound may be helpful in the diagnosis of complications of femoral hernia; incarceration by observing the blood supply in the contents of the hernia sac.[1]
Sequence of diagnostic studies
The ultrasound should be performed when:[2]
- The patient presented with swelling or lump in the upper thigh as the first step of diagnosis.
- If it is an emergent case with signs of incarceration, abdominal CT scan can be performed to confirm the diagnosis.
References
- ↑ 1.0 1.1 1.2 Yang XF, Liu JL (2014). “Acute incarcerated external abdominal hernia”. Ann Transl Med. 2 (11): 110. doi:10.3978/j.issn.2305-5839.2014.11.05. PMC 4245506. PMID 25489584.
- ↑ 2.0 2.1 Whalen, H. R.; Kidd, G. A.; O’Dwyer, P. J. (2011). “Femoral hernias”. BMJ. 343 (dec08 1): d7668–d7668. doi:10.1136/bmj.d7668. ISSN 0959-8138.
- ↑ Bradley M, Morgan D, Pentlow B, Roe A (2003). “The groin hernia – an ultrasound diagnosis?”. Ann R Coll Surg Engl. 85 (3): 178–80. doi:10.1308/003588403321661334. PMC 1964363. PMID 12831490.
- ↑ Djuric-Stefanovic A, Saranovic D, Ivanovic A, Masulovic D, Zuvela M, Bjelovic M, Pesko P (2008). “The accuracy of ultrasonography in classification of groin hernias according to the criteria of the unified classification system”. Hernia. 12 (4): 395–400. doi:10.1007/s10029-008-0352-6. PMID 18293054.
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