Relationship between ultrasonic differential diagnosis of inguinal hernia and etiology

Objective To explore the value of ultrasound in differential diagnosis and typing of inguinal hernia, and to provide important reference for choosing the best way for clinical surgery. Methods One hundred and seventy-six patients with clinical suspicious inguinal hernia underwent ultrasonography, the ultrasonic features and blood supply situation of lesions in groin area, the relationship between surrounding tissue and blood vessels were recorded, the results were compared with those of surgery. Results In 176 patients, there were 173 cases consistent with surgery(173/176, 98.3%) , including 146 cases of indirect hernia, the diameter of hernia door was 3 cm, hernia content passed through inner loop, the inguinal canal and subcutaneous ring to scrotum to form abnormal echo mass, the changes of abdominal wall could be observed, the hernial sac was located anterior to the spermatic vein and lateral to inferior epigastric artery and vein. When the abdominal pressure was increased, the thickening of bowel wall was observed with indefinite structure in the hernia content. There were 27 cases of direct hernia, the diameter of hernia door was 4 cm, hernia content passed through Hesselbach triangle and went forward to form abnormal echo mass in the groin area, there was no changes in the abdominal wall. The hernial sac was located medical and posterior to the spermatic vein and medical to inferior epigastric artery and vein. When the abdominal pressure was increased, thinning of the bowel wall was observed and the structure was clear in the sac. Conclusion Ultrasound can differentiate direct and indirect hernia according to the size of hernia door, abdominal wall thickness before and after changing the abdominal pressure, relationship between hernia content, hernial sac and abdominal wall artery, it is the first line imaging method for diagnosis and typing of hernia before operation.