Accuracy of the ultrasound examination in patients with inguinal hernia.

ABSTRACT Objective: to evaluate the accuracy of ultrasonography in the diagnosis of inguinal hernia in the preoperative period of patients submitted to inguinal herniorrhaphy. Methods: we conducted a retrospective, descriptive, analytical study, based on data obtained from the charts of patients submitted to inguinal herniorrhaphy between January 2016 and December 2017 and who underwent ultrasonography in the preoperative period. The sample consisted of 232 patients, and we compared the results of the ultrasonography with the complaints, physical examination and intraoperative findings. Results: ultrasonography was in agreement with inguinal hernia complaint in 52% of patients (p=0.019). There was a disagreement between the percentage of patients who presented a hernia at the physical examination not confirmed by the ultrasound examination (28.57%) and the percentage of hernias identified only by the complementary examination (8.93%), with statistical significance (p=0.0291). When comparing the ultrasound findings with the intraoperative ones, 32.70% of patients presenting with hernia had normal ultrasonography, with statistical significance for discordance (p=0.001). Conclusion: ultrasound was an unreliable method to help diagnosis in dubious cases of inguinal hernia, and dispensable when the diagnosis was confirmed by typical complaints and compatible physical examination.

摘要
目的：评估接受腹股沟疝修补术（inguinal herniorrhaphy）的患者术前超声检查（ultrasonography）对腹股沟疝（inguinal hernia）的诊断准确性。
方法：本研究为回顾性描述分析性研究，数据来源于2016年1月至2017年12月期间接受腹股沟疝修补术且术前接受超声检查的患者病历。研究样本共纳入232例患者，将超声检查结果与患者主诉、体格检查及术中所见进行对比分析。
结果：超声检查结果与腹股沟疝主诉相符的患者占比为52%（p=0.019）。体格检查提示存在疝但超声检查未检出的患者占比（28.57%），与仅通过补充检查检出疝的患者占比（8.93%）之间存在显著不一致，且差异具有统计学意义（p=0.0291）。将超声检查结果与术中所见对比时，32.70%的经术中证实为腹股沟疝的患者超声检查结果正常，二者不一致的差异具有统计学意义（p=0.001）。
结论：对于可疑腹股沟疝病例，超声检查并非可靠的辅助诊断手段；若患者存在典型主诉且体格检查结果符合疝的表现，则超声检查并非必需。