TY - JOUR
T1 - Ultrasonographic diagnosis for potential contralateral inguinal hernia in children
AU - Toki, Akira
AU - Watanabe, Yasuhiro
AU - Sasaki, Kiyoshi
AU - Tani, Morimichi
AU - Ogura, Kaoru
AU - Wang, Zhong Qiu
AU - Wei, Sun
PY - 2003/1/1
Y1 - 2003/1/1
N2 - Purpose: The authors describe the diagnostic approach and the reliability of the diagnosis using their ultrasonographic classification for potential contralateral inguinal hernia in children. Methods: In children presenting with unilateral inguinal hernia, the contralateral processus vaginalis in the inguinal canal was examined preoperatively by ultrasonography with a 10-MHz transducer. The findings, with increment and decrement of the intraabdominal pressure, were categorized into 6 types as follows: type I, the intraabdominal organ is observed in the inguinal canal; type II, the patent processus vaginalis (PPV) is seen cystlike at the internal ring of the inguinal canal; type III, the PPV is widened with abdominal pressure increment (the length of the PPV is longer than 20 mm); type IV, the PPV contains moving fluid without PPV widening; type V, the PPV is widened with abdominal pressure increment (the length is shorter than 20 mm); type VI, others. Types I through IV were regarded as potential candidates for inguinal hernia. The diagnostic performance of the clinical examination, with or without the assistance of ultrasonography was analyzed retrospectively. Results: The development rates of contralateral inguinal hernia following unilateral herniorrhaphy, before and after application of ultrasonographic diagnosis, were 10.2% (28 of 274 cases) and 1.5% (4 of 271 cases), respectively. The difference was statistically significant according to Fisher's Exact probability test. Conclusions: Contralateral herniorrhaphy should be performed on inguinal hernia candidates when ultrasonography shows types I through IV.
AB - Purpose: The authors describe the diagnostic approach and the reliability of the diagnosis using their ultrasonographic classification for potential contralateral inguinal hernia in children. Methods: In children presenting with unilateral inguinal hernia, the contralateral processus vaginalis in the inguinal canal was examined preoperatively by ultrasonography with a 10-MHz transducer. The findings, with increment and decrement of the intraabdominal pressure, were categorized into 6 types as follows: type I, the intraabdominal organ is observed in the inguinal canal; type II, the patent processus vaginalis (PPV) is seen cystlike at the internal ring of the inguinal canal; type III, the PPV is widened with abdominal pressure increment (the length of the PPV is longer than 20 mm); type IV, the PPV contains moving fluid without PPV widening; type V, the PPV is widened with abdominal pressure increment (the length is shorter than 20 mm); type VI, others. Types I through IV were regarded as potential candidates for inguinal hernia. The diagnostic performance of the clinical examination, with or without the assistance of ultrasonography was analyzed retrospectively. Results: The development rates of contralateral inguinal hernia following unilateral herniorrhaphy, before and after application of ultrasonographic diagnosis, were 10.2% (28 of 274 cases) and 1.5% (4 of 271 cases), respectively. The difference was statistically significant according to Fisher's Exact probability test. Conclusions: Contralateral herniorrhaphy should be performed on inguinal hernia candidates when ultrasonography shows types I through IV.
KW - Contralateral inguinal hernia
KW - Diagnosis
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=0037308833&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037308833&partnerID=8YFLogxK
U2 - 10.1053/jpsu.2003.50048
DO - 10.1053/jpsu.2003.50048
M3 - Article
C2 - 12596108
AN - SCOPUS:0037308833
VL - 38
SP - 224
EP - 226
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 2
ER -