Sonographic Evaluation of Clinically Occult Inguinal Hernias in Patients With Scrotal Pain and Normal Scrotal Color Doppler Sonography

摘要

Scrotal pain, whether acute or chronic, is a common clinical presentation that can be caused by a diverse array of disorders involving different anatomic structures. Because of pain and guarding, patients are usually incooprative for physical examination and thus, not be reliable. This makes definitive diagnosis difficult for even the most experienced clinician. Sonography can be invaluable in evaluating of patient with scrotal pain. The aim of this study is to assess the prevalence of accult inguinal hernia in patients with scorotal pain who have normal physical examination and normal scorotal color Doppler sonography to improve the weakness of clinical diagnosis. A total of 101 patients who have scrotal pain, were referred prospectively with clinically normal physical examination and normal scorotal color Doppler sonography for ultrasound examinations of occult inguinal hernia. Also we evaluate prevalence of unilateral or bilateral occult inguinal hernia and direct or indirect occult inguinal hernia. Overall, with mean age of 29.4 ± 7.56 years ,mean wight of 76.5 ± 9.52 kilogram and mean symtoms duration of 11.9 ± 9.15 days, scans showed 51.5% occult direct inguinal hernia,14% occult indirect inguinal hernia and 35% with no evidence of hernia.11.9% of patients have bilateral hernia, 21.8% have left inguinal hernia and 31.7% have right inguinal hernia. A higher incidence of inguinal hernia was associated with age increasement (p = 0.015) and weight increasement (P= 0.01). In conclusion, with achieved prevalence of occult hernia (65.5%), in patients with scorotal pain who have normal physical examination and normal scorotal color Doppler sonography in this study, we recommend ultrasonographic evaluation for these patients, since it's noninvasive and available.