Diagnosis and treatment of occult indirect inguinal hernia (A report of 60 cases) / 中国微创外科杂志

Ojective To enhance the ability of diagnosis and therapy for occult indirect inguinal hernia. Methods Surgical exploration was performed for patients highly suspected with occult indirect inguinal hernia based on clinical manifestations and physical examinations in the initial stage. At present, herniography was used to confirm the diagnosis. High ligation of the hernial sac, non-mesh methods of open groin hernia repair or tension-free inguinal hernia repair was performed for the patients. Results Forty-four cases were given surgical exploration in the initial stage and 41 cases were confirmed and treated by operation. Misdiagnosis was found in 3 cases and surgical exploration revealed no sign of disease. Relapse occurred in two cases within 5 years. Nineteen out of 30 patients were confirmed by herniography in the last five years and operated on. There was no false-positive herniogram in this series. Follow-up evaluation of the patients showed disappearance of preoperative symptoms. Groin hernia has not recurred so far. Conclusions The ability of diagnosis for occult indirect inguinal hernia can be enhanced by herniography. Blind surgical exploration can be reduced. Herniography is a safe, reliable and practical diagnostic procedure.

Herniography in the diagnosis of occult or recurrent inguinal indirect hernia / 中国普通外科杂志

ObjectiveTo improve the diagnosis of occult or recurrent inguinal indirect hernias. Methods 47 patients with obscure groin or incisional pain with normal physical examinations were undergone herniography. Results26 patients had hernias confirmed by herniography, including 22 indirect and 4 recurrent hernias. The symptoms disappeared after herniorrhaphy in the 26 patients. Eighteen of the other 21 patients with normal herniography were asymptomatic via other treatment 3 months after herniography. Conclusions Herniography is useful to diagnose the occult or recurrent inguinal indirect hernias in patients with inguinal region pain of unclear causes.

The usefulness of herniography on the hydrocele in pediatric age / 대한비뇨기과학회지

The incomplete obliteration of the processus vaginalis leads to the development of inguinal hernia in pediatric age, and its management is principally surgical repair. This study was a review and analysis of the usefulness of herniography on the hydrocele in pediatric age. From January 1985 to June 1989, 117 patients with unilateral hydrocele were studied to evaluate incomplete obliteration of the processus vaginalis. The over-all incidence of open processus vaginalis on the opposite side was 6.9% (8 of 117 cases), but the rate of patients who had past history of a palpable or visualized mass on the opposite side was 5%(3 of 12 cases). This finding would suggest that the herniogram is needed for the patients whose history is suspicious for hydrocele testis.

Diagnostic Evaluation of Herniography in Cryptorchism / 대한비뇨기과학회지

Herniography is proved to be a valuable roentgenographic technique for delineating the configuration of almost all the peritoneal sacs and the position of most of the undescended testes, as well as most of the associated urologic anomalies. The authors applies this technique to thirty three boys with cryptorchism (39.4% bilateral) in this department during last 3 years and 6 months period from Jan. 1978 to June 1981. The results were as follows. 1) There were 40 open peritoneal sacs at operation, including 3 open sacs contralateral to unilateral cryptorchid testes. With the most accurate preoperative examination only 19 of these open sacs were noted (47.5%), while with herniography, 38 of the 40 were correctly identified (95.0%). 2) The position of the cryptorchid testes were accurately diagnosed by preoperative examination in 28 of the 45 instances (62.2%) With herniography we correctly located 33 testes (73.3%), despite the lack of an accompanying peritoneal sac with 8 cryptorchid testes (17.8%). 3) Associated anomalies and diseases were found in 24 instances of 33 boys, 2 of these 24 instances were discovered by the incidental pyelogram film of the herniogram to have upper urinary tract abnormalities, including one with ureteral stone and one with kidney malrotation. 4) Only 6 minor complications arose in 33 children as a result of this procedure, including 3 with abdominal injection, one with inadvertently needling of the colon, one with pain & sweating, one with transient fever. However, all of these were not troublesome for affected patients.