Imaging of Hernias

Abstract

Abdominal wall hernias are usually suggested by the patient's history and confirmed by physical examination; however, the history may be not typical, especially in patients with abdominal pain, distention, and overweight patients or in patients with small hernias located in unusual sites. Although most abdominal hernias are asymptomatic, the fear of developing complications like irreducibility, incarceration, and strangulation may necessitate prophylactic surgical repair; thus, early and accurate diagnosis is important. Before 20 years, herniorrhaphy was considered for imaging of hernias; however, in recent years, computed tomography (CT) (especially multidetector CT (MDCT)), together with ultrasound represented the mainstay of the diagnosis of abdominopelvic wall hernias by imaging, and magnetic resonance imaging (MRI) could be used as a diagnostic aid in a minority of the cases. Each imaging modality has its own privilege. The main advantage of ultrasound is the dynamic ability for assessment, while the main advantage of computed tomography is the multiplanar reformatting, allowing identification and accurate diagnosis of the hernia type, its content, and also the associated complications. Radiologists should be familiar with common sites of hernias and their detailed normal anatomy in order to reach the diagnosis easily.

Umbilical Hernias in Adults: Epidemiology, Diagnosis and Treatment

“…Imaging has an important role in the definitive diagnosis. In fact, clinical examination alone cannot exclude the diagnosis of hernia [11].…”