Dynamic ultrasound evaluation of the inguinal hernia

Dynamic ultrasound (US) evaluation can be a useful tool in the diagnosis of the complex clinical entity: inguinal hernia. Vasileff et al. (2018) state that the criterion used to diagnose inguinal hernias by US is movement of bowel, bladder, or omental lipomatous tissue in any combination anterior to the inferior epigastric vessels with or without Valsalva maneuver. A direct inguinal hernia is defined as tissue movement medial to the inferior epigastric vessels. An indirect inguinal hernia was defined as tissue movement lateral to the inferior epigastric vessels extending medially over the vessels. A femoral hernia is defined as tissue movement medial to the femoral vessels and deep to the inguinal ligament. An obturator hernia is defined as tissue movement through the obturator foramen.

Diagnosing inguinal hernia over US requires knowledge of (sono)anatomy, detailed pathology and a learning curve to get skilled to improve diagnostic accuracy.