Diagnostic Accuracy of Physical Examination versus Dynamic Ultrasonography in Evaluating Ventral Hernias: A Prospective Open-label Study

• Published in: International journal of anatomy radiology and surgery Vol. 14; no. 2; pp. RO12 - RO16
• Main Authors: Pant, Mukesh, Singh, Rohit, Ahmad, Shabi, Yadav, Dev Kumar, Singh, Virendra
• Format: Journal Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd 01.03.2025
• Subjects: abdominal swelling; european hernia society; ultrasound scans
• ISSN: 2277-8543; 2455-6874; 2455-6874
• DOI: 10.7860/IJARS/2025/76828.3044

Introduction: An abdominal hernia occurs when abdominal contents protrude through a weakness in the abdominal wall. Ventral and lumbar hernias are the most common types. Factors such as anatomical weaknesses, trauma and obesity can contribute to herniation. Diagnosis typically involves physical examinations, ultrasonography, Computed Tomography (CT) scans (the gold standard), Magnetic Resonance Imaging (MRI) and laparoscopy. Aim: To compare the diagnostic accuracy of physical examinations and dynamic ultrasonography in detecting ventral hernias, focusing on sensitivity, specificity and predictive values. Materials and Methods: This prospective open-label study was conducted in the Department of Surgery in collaboration with the Department of Radiodiagnosis at Swaroop Rani Nehru Hospital in Prayagraj, Uttar Pradesh, India affiliated with Moti Lal Nehru Medical College, Prayagraj, from September 2019 to September 2020. It involved participants aged 16 years and older who presented with abdominal swelling and were scheduled for hernia repair. The intraoperative findings, considered the gold standard, were compared with the results of clinical examinations and dynamic ultrasonography during surgery. The sensitivity, specificity and predictive values for the surgeon’s physical examination and dynamic ultrasonography were calculated. Results: This study involved 60 patients aged 16 to 65 years, with 31 patients (52%) in the 16 to 40 age range. There were slightly more females 33 (55%) than males 27 (45%). Medical histories indicated that 20 patients (33.33%) were smokers, 11 had diabetes (18.33%), two had Chronic Obstructive Pulmonary Disease (COPD) (3.33%), five had infections (8.33%) and five had anaemia (8.33%), while 17 patients (28.33%) reported no co-morbidities. The main symptoms were pain in 38 patients (63.33%) and swelling in 22 patients (36.66%). Physical examinations found 47 hernia-positive cases and 13 negative ones; dynamic ultrasonography confirmed 49 positives. Surgical findings revealed that 52 patients had a hernia, while eight were diagnosed with other conditions like lipoma and muscular weakness. Conclusion: This study demonstrated that ultrasound scans are practical tools for diagnosing unclear ventral hernias.