Audit of ultrasound and decision to operate in groin pain of unknown aetiology with ultrasound technique explained

AimTo determine the ability of a groin ultrasound service to identify inguinal/femoral hernias in patients with groin pain and equivocal clinical signs, and to evaluate the number of positive cases undergoing surgery.Methods and materialsA retrospective review of 243 examinations performed during the period January 2000 to June 2004 was undertaken. The referral information, as well as details of the examination and subsequent follow-up, were obtained through our hospital/radiological information system.ResultsOf 243 patients, 92 (38%) were referrals from general practitioners and 151 (62%) were hospital referrals. The examinations were performed by radiology consultants or specialist registrars, the former accounting for 228 examinations (94%). The age range of the patients was 3 months to 88 years (mean age = 48.7), with a male to female ratio of 3.2:1. One hundred and forty-three examinations were negative for hernias. Two of these patients underwent groin explorations and were found to be normal. The rest were discharged and none returned with related complaints. Ninety-four examinations (39%) were positive for hernias, as a result of which 62 patients underwent surgery. Of these, only four were found to be false-positives giving a positive predictive value of 94% in operated patients. Three scans were equivocal, and three were positive for other conditions.ConclusionIn patients with equivocal clinical signs, groin ultrasound is a useful tool for identifying hernias, and therefore, aids surgical management.