• J. Surg. Res. · Sep 2020

    Observational Study

    Prevalence and Impact on Quality of Life of Occult Hernias among Patients Undergoing Computed Tomography.

    • Oscar A Olavarria, Karla Bernardi, Julie L Holihan, Nicole B Lyons, Puja Shah, Tien C Ko, Lillian S Kao, and Mike K Liang.
    • Department of Surgery, McGovern Medical School at the University of Texas Health Science Center Houston, Houston, Texas; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas. Electronic address: oscar.a.olavarria@uth.tmc.edu.
    • J. Surg. Res. 2020 Sep 1; 253: 121-126.

    BackgroundWith the widespread use of advanced imaging there is a need to quantify the prevalence and impact of hernias. We aimed to determine the prevalence of abdominal wall hernias among patients undergoing computed tomography (CT) scans and their impact on abdominal wall quality of life (AW-QOL).MethodsPatients undergoing elective CT abdomen/pelvis scans were enrolled. Standardized physical examinations were performed by surgeons blinded to the CT scan results. AW-QOL was measured through the modified Activities Assessment Scale. On this scale, 1 is poor AW-QOL, 100 is perfect, and a change of 7 is the minimum clinically important difference. Three surgeons reviewed the CT scans for the presence of ventral or groin hernias. The number of patients and the median AW-QOL scores were determined for three groups: no hernia, hernias only seen on imaging (occult hernias), and clinically apparent hernias.ResultsA total of 246 patients were enrolled. Physical examination detected 62 (25.2%) patients with a hernia while CT scan revealed 107 (43.5%) with occult hernias. The median (interquartile range) AW-QOL of patients per group was no hernia = 84 (46), occult hernia = 77 (57), and clinically apparent hernia = 62 (55).ConclusionsOne-fourth of individuals undergoing CT abdomen/pelvis scans have a clinical hernia, whereas nearly half have an occult hernia. Compared with individuals with no hernias, patients with clinically apparent or occult hernias have a lower AW-QOL (by 22 and seven points, respectively). Further studies are needed to determine natural history of AW-QOL and best treatment strategies for patients with occult hernias.Copyright © 2020 Elsevier Inc. All rights reserved.

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