Evaluation of dynamic ultrasound scanning in the diagnosis of equivocal ventral hernias with surgical comparison

OBJECTIVES: This study aims to compare ultrasonography for ventral hernias with surgical findings and establish its accuracy in equivocal cases. Comparison is also made against groin hernia ultrasound scanning, which has a positive predictive value ranging from 71-100%. METHODS: A retrospective review of all patients who underwent an ultrasound scan between June 2011 and June 2015 was performed. The word "hernia" in the referral information was the sole inclusioncriterion. Patients who were found to have a clinically evident ventral hernia, unrelated hernia in aseparate location or had a known hernia were excluded. Thus, only patients with a clinically suspected ventral hernia and equivocal clinical assessment were included. These patients were followed up for at least 12 months and subsequent operation notes, if any, were also analysed. RESULTS: 348 scans were included (F = 198, M = 150, F:M ratio = 1.32:1). The mean age was 53.4 years (range = 16-97 years). 101 scans were positive for hernias (29.0%), 190 were negative (54.3%), and 57 had other findings (e.g. seroma, lipoma; 16.3%). 54 patients were taken to surgery (15.5%), including 5 who were found to be negative on ultrasound. Of these, 45 were truepositives, 4 true-negatives, 4 false-negatives, and 1 false-positive, giving a sensitivity of 91.8% and positive predictive value of 97.8%. CONCLUSION: This study confirms that ultrasound scans are effective in the diagnosis of equivocal ventral hernias. Advances in knowledge: The accuracy of ultrasound scanning specifically for ventral hernias is quantified, and are comparable to that of groin hernias.