ArticleHernia : the journal of hernias and abdominal wall surgery2024
Recommendations for the diagnosis of occult inguinal hernias using a modified Delphi technique.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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9 authors.
Funding
Abstract
backgroundOccult inguinal hernias are inguinal hernias that are not felt on physical exam but can often be seen on imaging. Their diagnosis can be challenging, leading to unnecessary surgeon referrals, undue patient stress, and even unneeded surgery. The aim of this project was to develop recommendations for the diagnosis of occult inguinal hernias using a modified Delphi technique.
methodsIterative rounds of surveys were administered to an expert panel of surgeons and radiologists. Panelists were asked to rate potential hernia-related topics by levels of importance. Items with 80% agreement were included for further discussion. Panelists were asked to provide their opinion on each included subject. A virtual meeting was conducted to discuss areas without agreement and determine final recommendations.
resultsThree surgeons and five radiologists participated. There was strong agreement that dynamic ultrasound is a good first/confirmatory imaging choice. There was agreement that the radiology reports for studies assessing inguinal hernias should include hernia contents (80%) and hernia size (100%). Information that should be provided to the radiologist when ordering an imaging study include indication for study, patient symptoms, prior hernia surgery. Items that should be included in a radiology report include whether the presence of an inguinal hernia was assessed, hernia contents, size of defect, +/- hernia type.
conclusionsThis collaboration between surgeons and radiologists creates a diagnostic imaging pathway and standardizing imaging reporting which will be used to improve the diagnosis of occult inguinal hernias. Future studies testing these recommendations in a prospective study are warranted.
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