Value of Ultrasonography in the Diagnosis of Inguinal Hernia – A Retrospective Study

2018 ◽  
Vol 39 (06) ◽  
pp. 690-696 ◽  
Author(s):  
Tanja Maisenbacher ◽  
Wolfgang Kratzer ◽  
Andrea Formentini ◽  
Julian Schmidberger ◽  
Tanja Kaltenbach ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Retrospective Study ◽  
Clinical Examination ◽  
Predictive Value ◽  
High Sensitivity ◽  
Accurate Method ◽  
Diagnostic Value ◽  
Inguinal Hernias ◽  
Ultrasound Findings ◽  
The Right

Abstract Purpose The diagnosis of an inguinal hernia is usually made clinically. Precise imaging appears to be necessary when the clinical examination is inconclusive. The aim of this study was to determine the diagnostic value of ultrasonography for inguinal hernias and whether it influences the decision for or against surgery. Materials and Methods This study was a single-center retrospective study carried out from January 2012 to December 2016. All 326 patients had undergone ultrasound scanning of the groin as part of the diagnostic workup. Besides surgical findings being the gold standard, follow-up data and alternative ultrasound diagnoses were considered as references, allowing us to assess the accuracy of negative ultrasound findings as well. Results The findings on ultrasonography were positive in 248 patients and negative in 78 patients. In addition to 201 operated patients, we were able to validate a further 40 patients by means of a questionnaire and the alternative ultrasound diagnoses. The correlation with all three references resulted in a sensitivity of 97 %, a specificity of 77 %, a positive predictive value of 95 %, and a negative predictive value of 87 %. Conclusion Ultrasonography is an accurate method for evaluating inguinal hernias. High sensitivity makes it particularly suitable for ruling out an inguinal hernia when the findings are negative. An ultrasound scan carried out in addition to clinical examination can therefore help to determine the right indication for surgical intervention.

Overuse of Previsit Ultrasound in Patients Referred for Treatment of Inguinal Hernias

2019 ◽  
Vol 85 (3) ◽  
pp. 261-265
Author(s):  
Bryce French ◽  
Caleb Van Essen ◽  
Christopher Mcdonald ◽  
Andrew Ting
Keyword(s):  
Health Care ◽  
Inguinal Hernia ◽  
Physical Examination ◽  
Sensitivity And Specificity ◽  
Clinical Examination ◽  
Medical Records ◽  
High Sensitivity ◽  
Patient Demographics ◽  
Inguinal Hernias ◽  
Case Outcome

Inguinal ultrasound (US) has a high sensitivity and specificity for the diagnosis of inguinal hernias but is often performed unnecessarily, adding cost and time to treatment. The aim of our study was to assess the rate and necessity of US before clinical examination by a hernia surgeon. Medical records of patients referred for an inguinal hernia from April through July 2017 were reviewed. These cases were analyzed for patient demographics, physical examination (PE) findings, previsit imaging, health-care system of surgeon, and case outcome. Twenty-nine per cent of patients had an inguinal US before visiting a surgeon. Sixty-three per cent of patients who underwent an US had a palpable hernia on PE, and 76 per cent had a positive PE by the surgeon. Patients without a hernia on referring provider's PE underwent US 59 per cent of the time. Inguinal USs are being ordered unnecessarily by referring providers. Physical examination by referring providers and surgeons should be the primary tool for diagnosis of an inguinal hernia.

scholarly journals Interest of Ultrasound in the Exploration of Rotator Cuff Lesions - Confrontation of Clinical Examination and Ultrasound Finding

2018 ◽  
Vol 5 ◽  
Author(s):  
Nessrine Akasbi ◽  
Asmae El Aissaoui ◽  
Ikrame Yazghich ◽  
Samira El Fakir ◽  
Taoufik Harzy
Keyword(s):  
Rotator Cuff ◽  
Physical Examination ◽  
Clinical Examination ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Ultrasound Finding ◽  
X Ray ◽  
Rotator Cuff Lesion ◽  
Rotator Cuff Lesions ◽  
A Prospective Study

Introduction: The aim of our study was to evaluate the interest of ultrasound in the exploration of painful shoulders evoking rotator cuff lesions and to determine the diagnostic value of the different tendon tests through a confrontation physical examination versus shoulder ultrasound. Materials and methods: A prospective study was conducted including patients consulting for shoulder pain that suggests a rotator cuff lesion. All patients underwent a clinical examination, an x ray and shoulder ultrasound.Results: The confrontation physical examination versus shoulder ultrasound showed that Jobe's test is very sensitive (100%) but less specific (27%), the Patte test, has a high sensitivity (100%) but an average specificity (51%), the Palm-Up test was fairly sensitive (91%) but not very specific (43%) and the Gerber test was more specific (95.7%) and less sensitive (38%). The comparison between x ray and ultrasound showed that ultrasound of shoulder is more efficient in the detection of calcifications and erosions of humeral head.Conclusion: Ultrasound of shoulder is more performant than physical examination and x ray in exploring the rotator cuff lesions.

scholarly journals Open Maloney Repair for Adult Inguinal Hernia, 5 Years Experience in A Remote District

2018 ◽  
Vol 10 (1) ◽  
pp. 6-10
Author(s):  
Sami Ahmad ◽  
Nadim Ahmed ◽  
Jawher Lal Singha ◽  
Ferdoush Rayhan ◽  
ASM Farhad Ul Hassan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Average Duration ◽  
Study Group ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Secondary Closure ◽  
The Right

Background: In a remote district city of Bangladesh, inguinal hernias were repaired by Maloney (Darning) method.Efficacy of Darning repair was compared in this study.Aims and Objectives: The aim of this study was to determine the feasibility of doing Maloney ( Darn ) repair for adult inguinal hernias by specialist surgeons at remote districts . Age of the patients in ourstudy were above 20 years.Study Design: A descriptive retrospective study.Materials and Methods:In our study we included 2000 patient of inguinal hernia surgery repairs from May 2012 through June 2017. In the patients of the study group we repaired inguinal hernia by Maloney ( Darning) technique. Number of patients were 2000 ( male 1990 [99.5%] female 10 [.5%] with a mean age of 45.7 years. There were 1002(50.1%) hernias on the right side, 890(44.5%) were on the left side and 108(5.4%) were bilateral. Among the hernias 1419 ( 70.9%) were indirect, 575 (28.7%) were direct and 4 (0.2%) were of both direct and indirect (Pantoolon type), 2 (0.1%) were of femoral hernia. All were of primary hernias, recurrent hernias and hernias in patients with apparently weak musculature were repaired by Lychtenistein method with prolein mesh and were not included in this stpudy. 60 (3%) patients had feature of incarceration and 20 (1%) patients presented with obstruction. Among the obstructed hernias 8 (.4%) had strangulation and in 2 (.1%) resection and anastomosis were required for gangrenous ileum. In rest of the cases of strangulation circulation returned after incising the constricting ring and hot mob compression. We used IV antibiotic for 24 hours stated with induction of anaesthesia followed by oral for next 6 days. We used Injection Ceftrixone followed by Cefixime and in some patients Flucloxacillin.Statistics Analysis Used: Simple frequencies, proportion and cross tabulation.Results: Average duration of surgery was 70 minutes. There was no perioperative mortality. 90 (4.5%) patients developed mild subcutaneous wound infection, haematoma occurred in 160 ( 8% ) patients and seroma found in 300 ( 15% ) patients. All haematoma and seroma subsided gradually. Only 1 patient needed secondary closure for infected wound gap. The average duration of hospitalization was 3 days. All patients in study group are still in contact with me. Three patients (0.15%) had recurrences. All the recurrent cases reported within 6 months of their operations. Among the three age of 2 patients was above 60 and one patient of age above 70 had Maloney hernia repair for obstructed hernia.Conclusion:In remote places where prolene mesh is not available or is costly we can repair inguinal hernia by Maloney operation with very simple antibiotics with good results in comparison with other methods.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 6-10

scholarly journals Incidence of the Finger Defect in Golden Jubilee Medical Center: A 2-Year Retrospective Study

2014 ◽  
Vol 5 (3) ◽  
pp. 143-146
Author(s):  
Pokpong Amornvit ◽  
Sahana Bajracharya ◽  
Dinesh Rokaya ◽  
Konrawee Keawcharoen ◽  
Somchart Raucharernporn ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Examination ◽  
Medical Center ◽  
Nomenclature System ◽  
Finger Injuries ◽  
Right Hand ◽  
Golden Jubilee ◽  
The Right

ABSTRACT The study was done to see the incidence of the finger defect and to develop a nomenclature system with the help of questionnaire, clinical examination, and radiographs of the finger defects obtained in two standard planes. The results of this study demonstrate that finger injuries were common males than females and the defect was more common in the right hand and in middle fingers. Amputation was more common at the level of distal phalanges. How to cite this article Amornvit P, Bajracharya S, Rokaya D, Keawcharoen K, Raucharernporn S, Thongpulsawasdi N. Incidence of the Finger Defect in Golden Jubilee Medical Center: A 2-Year Retrospective Study. World J Dent 2014; 5(3):143-146.

Diagnostic Value of a New Sensitive Membrane Based Technique for Instantaneous D-Dimer Evaluation in Patients with Clinically Suspected Deep Venous Thrombosis

1997 ◽  
Vol 77 (04) ◽  
pp. 637-640 ◽  
Author(s):  
Christophe Leroyer ◽  
Martine Escoffre ◽  
Emmanuelle Le Moigne ◽  
Marc Grimaux ◽  
Olivier Cagnioncle ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Predictive Value ◽  
Clinical Signs ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Lower Sensitivity ◽  
Predictive Values ◽  
Study Results ◽  
D Dimer

SummaryBackground: Plasma D-Dimer analysis, using ELISA assays, has demonstrated in previous studies a high sensitivity, suggesting its utility in excluding deep venous thrombosis (DVT). Aim: To assess the performance of a new rapid plasma D-Dimer ELISA measurement in suspected DVT patients with recent clinical signs, not exceeding one week. Methods: A prospective study of patients admitted for a suspected recent DVT. Contrast venography or compression ultrasonography were performed within 24 h of admission. A new membrane based ELISA technique, which uses an immunofiltration and two complementary monoclonal antibodies was tested. Results were expressed as positive or negative. A standard plasma D-Dimer ELISA measurement was also performed. D-Dimer performances were assessed at the end of the study. Results: 265/448 patients had a proven DVT (72 distal, 193 proximal). The sensitivity of the instantaneous method in the diagnosis of overall DVT is 92 ± 3.4% (95% Cl), and specificity is 36.6 ± 6.9%. Positive predictive value is 67.7 ± 4.8% and negative predictive value is 76.1 ± 8.9%. Sensitivity and negative predictive values reach 97.9 and 94.3% in the diagnosis of proximal DVT, but only 76.3 and 79.7% in the diagnosis of distal DVT. Similar results are observed with the standard ELISA method. Conclusion: This new rapid plasma D-Dimer measurement appears highly sensitive, and could substitute the older ELISA methods. Both methods provide lower sensitivity in the case of a distal DVT location.

Feasibility of Thyroid Imaging Reporting and Data System Classification in Predicting Thyroid Malignancy

2019 ◽  
Vol 85 (12) ◽  
pp. 1345-1349
Author(s):  
Ahmet Cem Dural ◽  
Nuri Alper Sahbaz ◽  
Cevher Akarsu ◽  
Sezer Akbulut ◽  
Rustu Turkay ◽  
...  
Keyword(s):  
Predictive Value ◽  
Daily Practice ◽  
Diagnostic Value ◽  
Data System ◽  
Thyroid Malignancy ◽  
Predictive Values ◽  
Thyroid Imaging ◽  
Ultrasound Findings ◽  
Risk Of Malignancy ◽  
Sensitivity Specificity

In this study, we aimed to evaluate the diagnostic value of thyroid imaging reporting and data system (TIRADS) in the estimation of malignancy and assess the concordance between TIRADS and the histopathology results of the postoperative specimens. Consecutive ultrasound imaging records of patients with multinodular goiter from January 2010 to December 2017 who underwent surgery were retrospectively reviewed. The risk of malignancy of each TIRADS category was determined, and correlation with pathology was assessed. The patients with malignant cytology findings (Bethesda 6) who were categorized TIRADS 6 were excluded from the study. The positive and negative predictive values, sensitivity, specificity, and accuracy of the TIRADS classification were calculated on a 2 x 2 table with their own formulas. A total of 1457 patients were evaluated, and 1122 of these were included in the study. The risk of malignancy for nodules evaluated as TIRADS 2 was 0.6 per cent, TIRADS 3 was 13.1 per cent, TIRADS 4a was 20 per cent, TIRADS 4b was 61.1 per cent, TIRADS 4c was 85.7 per cent, and TIRADS 5 was 93.3 per cent. The positive predictive value of TIRADS classification was found to be 43.4 per cent, negative predictive value was found to be 90.7 per cent, sensitivity was found to be 78 per cent, specificity was found to be 68.4 per cent, and accuracy was found to be 70.7 per cent for our institution. The TIRADS classification based on suspicious ultrasound findings is reliable in predicting thyroid malignancy and can be routinely used in daily practice.

THE DIAGNOSTIC VALUE OF ULTRASOUND IN DIAGNOSING CERTAIN COMMON LESIONS OF SHOULDER

2021 ◽  
Vol 62 (5) ◽  
Author(s):  
Nguyen Tien Long ◽  
Dang Bich Nguyet ◽  
Bui Van Lenh ◽  
Nguyen Quang Trung
Keyword(s):  
Retrospective Study ◽  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Standard Protocol ◽  
Full Thickness ◽  
Cuff Tear ◽  
Partial Thickness

The retrospective study was performed on 200 patients with painful shoulders who underwent ultrasound according to the standard protocol of the Radiology Centre of Hanoi Medical UniversityHospital. Out of these patients, 41 cases underwent arthroscopy. The results of ultrasound and arthroscopy were analyzed and compared in the assessment of the diagnostic value of ultrasound in lesions of shoulder.Results: Ultrasound detected 31.5% with partial-thickness rotator cuff tear, 21% with full-thickness rotator cuff tear and 20.5% with tendonitis. Ultrasound showed a sensitivity (Sn) of 80%, specificity(Sp) of 95.2%, positive predictive value (PPV) of 94.1%, negative predictive value (NPV) of 83.3% in diagnosing full-thickness rotator cuff tear. For partial-thickness rotator cuff tear, it showed a Snof 57.1%, Sp of 92.6%, PPV of 80%, NPV of 80.6%. In detection of tendonitis, Sn of ultrasound was 57.1%, Sp was 88.2%, PPV was 50%, NPV was 90%. Ultrasound showed a Sn of 39.3%, Sp of92.3%, PPV of 91.7%, NPV of 43.4% in evaluating subacromial-subdeltoid bursa.

scholarly journals Investigating the Diagnostic Value of Ultrasound in Determining the Opposite Inguinal Hernia in Children with Unilateral Inguinal Hernia Diagnosis

2020 ◽  
pp. 1-6
Author(s):  
Ashjaei Bahar ◽  
Ashjaei Bahar ◽  
Amiri Shakiba ◽  
Najdi Fatemeh ◽  
Movahedi Jadid Merisa
Keyword(s):  
Inguinal Hernia ◽  
Clinical Examination ◽  
Medical Center ◽  
Diagnostic Value ◽  
Bilateral Inguinal Hernia ◽  
Cross Sectional ◽  
Unilateral Inguinal Hernia ◽  
Center Hospital ◽  
Inguinal Hernia In Children

Objective: This study was conducted to evaluate and compare the results of ultrasound and clinical examination in the diagnosis of inguinal hernia in children and also to evaluate the benefits and complications of ultrasound in these children. Study Design: This study, was performed by a cross-sectional method in Children's Medical Center Hospital during 2013-2014 years and follow up was done until July 2020 with the help of a questionnaire from 70 children who had been referred due to unilateral inguinal hernia symptoms. All 70 children underwent Ultrasonographic evaluation and the results of the ultrasound were compared with the initial clinical examination and then with surgery and follow up. Results: In 95.7% of cases, uni or bilateral inguinal hernia was correctly diagnosed by ultrasound. Ultrasound revealed 13.4% of cases were bilateral and 86.6% were unilateral, all of which were confirmed by surgery. In 17.1% of cases, although they were referred with the chief complaint and clinical examination of unilateral inguinal hernia, Bilateral diagnosis was made for them during the ultrasound, and during the surgery, 75% of them were confirmed to have bilateral inguinal hernia. Conclusion: Ultrasound is effective in diagnosing the opposite side of the hernia in cases with unilateral hernia.

scholarly journals A comparative study of totally extraperitoneal versus transabdominal preperitoneal repair of inguinal hernias

2017 ◽  
Vol 4 (4) ◽  
pp. 1244
Author(s):  
Sudarshan P. B. ◽  
Sundaravadanan B. S. ◽  
Prabu Shankar S.
Keyword(s):  
Inguinal Hernia ◽  
Retrospective Study ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Repair ◽  
Laparoscopic Approach ◽  
Bilateral Hernia ◽  
Totally Extraperitoneal ◽  
Transabdominal Preperitoneal ◽  
Inguinal Hernias

Background: The two common procedures which are nowadays commonly performed for laparoscopic repair of inguinal hernia are transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) mesh repair. This retrospective study was aimed to compare these two, TAPP and TEP laparoscopic approaches for inguinal hernia repair in terms of various outcomes.Methods: In this retrospective study, we included 50 cases of inguinal hernia who underwent laparoscopic approach of inguinal hernia repair at Saveetha medical college and hospital between 2014 and 2016 for a duration of 3 years. Various parameters including the age, sex of patient, type of hernia, preoperative and post-operative complications, duration of hospital stay was analysed.Results: Of the 50 patients who underwent laparoscopic repair, 26 patients underwent TEP and 24 patients under went TAPP procedure. 31 cases were indirect inguinal hernias and 30 cases were direct inguinal hernias, totalling 61 hernia repairs, as 11 patients had bilateral hernia. One female inguinal hernia and 4 cases of recurrent hernia were operated by TAPP method. Postoperative complications like seroma formation; subcutaneous emphysema was seen in TEP group. Two cases of TEP were converted to TAPP and open lichenstein procedure. Postoperative pain was less in both the group. Patients who underwent TEP procedure spent less time in the hospital compared to those who underwent TAPP procedure.Conclusions: There is no major difference in the outcome after TEP and TAPP surgeries except for some minor complications and the results are comparable in both techniques TAPP and TEP. Both the procedures can be practiced according to surgeon’s familiarity of the procedure.

Clinical Examination is Superior to Plain Films to Diagnose Pelvic Fractures Compared to CT

2008 ◽  
Vol 74 (6) ◽  
pp. 476-480 ◽  
Author(s):  
TherÈSe M. Duane ◽  
Tracey Dechert ◽  
Luke G. Wolfe ◽  
Holly Brown ◽  
Michel B. Aboutanos ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Negative Predictive Value ◽  
Blunt Trauma ◽  
Clinical Examination ◽  
Glasgow Coma Scale Score ◽  
Predictive Value ◽  
Screening Tool ◽  
Pelvic Fractures ◽  
Plain Films ◽  
The Right

We prospectively compared clinical examination (CE) with plain films (PXR) and both tools with CT in patients sustaining blunt trauma. There were 1388 patients who had both PXR and CT of whom 168 (12.1%) were diagnosed with a fracture by CT. CE findings most predictive of fracture included age (OR, 1.025; CI, 1.011–1.039), hip pain (OR, 4.971; CI, 2.508–9.854), internal rotation of the leg (OR, 4.880; CI, 1.980–12.027), or tenderness to palpation over the sacrum (OR, 2.297; CI, 1.144–4.612), over the right or left hip (OR, 3.626; CI, 1.823–7.214), or diffusely throughout the pelvis (OR, 16.445; CI, 4.277–63.237). These factors were still predictive of pelvic fractures even in patients with a Glasgow Coma Scale score less than 13. There were 136 fractures identified by PXR all of which were identified by CE (sensitivity 100% [136 of 136], negative predictive value 100% [619 of 619]). There were six patients with negative clinical examinations and positive CTs (sensitivity 96.4% [162 of 168], negative predictive value 99.03% [613 of 619]), none of which were hemodynamically significant. The sensitivity for PXR compared with CT was 79.17 per cent (133 of 168) and the NPV was 97.2 per cent (1217 of 1252). CE is a reliable way to diagnose pelvic fractures and PXR is a poor screening tool for these injuries compared with CT. Because the majority of patients undergo CT after blunt trauma, routine screening radiographs should be eliminated.

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