MSCT performance of inguinal hernia with rare and special signs

Objective: To discuss the multi-slice CT (MSCT) manifestations in diagnosis of inguinal hernia with rare and special signs. Methods: CT images of 19 rare inguinal hernia cases were reviewed, 4 cases with plain scan and 15 cases with enhanced scan. The images were transferred to the workstation and image postprocessing were done to analyze the image characteristics and special signs. Results: Among the 19 patients, there were 12 cases of unilateral hernia and 7 cases of bilateral hernia. Of the 6 cases of huge hernia, the hernia contents were bladder, bowel, fat and peritoneum in 1 case and bowel and omentum in 5 cases. There were 6 cases with rare hernial content, including 5 cases of bladder herniation. CT showed bowel, peritoneum together with bladder, herniated into the scrotum in 1 case, while the rest were partial bladder herniation and the bladder showed dumbbell shape on CT image. 1 case of ureteral hernia into the scrotum showed the tortuous and dilated megaureter herniation into the scrotum accompanied by bilateral hydronephrosis. 5 cases of incarcerated hernia with intestinal obstruction manifested as expansion and pneumatosis of proximal bowel with gas-liquid plane. 2 cases of strangulated hernia showed no enhancement. Conclusion: MSCT can estimate the types of rare inguinal hernia correctly and determine the type, size and anatomical relationship of hernial contents. It can provide valuable imaging information for reasonable clinical treatment and prognosis judgment. (authors)