1069 Radiological Diagnosis of Groin Hernia - The New Norm?

Abstract

Abstract Aim Ultrasound is an effective means for diagnosis of groin hernia however, RCS England and The British Hernia Society recommend that herniae should be diagnosed clinically and ultrasound should not be arranged at a primary care level. Following an increase in radiologically-diagnosed herniae referred to the general surgery department, we sought to determine whether ultrasound was used as a primary diagnostic tool. Method Ultrasound requests received from primary care between January and December 2021 were identified using radiology department records. Exclusion of incomplete, follow up and paediatric scans (<16 years old) was ensured. Electronic records were reviewed for clinical history, examination, radiology request and imaging report. Results 342 patients were included. 193 patients had the right groin scanned and 149, the left. The predominant symptoms for which scans were requested were “lump/swelling” (46%) and “pain” (36%). 13% were for suspected recurrence. 27% had a hernia on examination and 45% had no documented examination findings. The most common clinical question on imaging requests was “?hernia” (63%). 143 (42%) of ultrasound scans positively identified a hernia. Of these, 52% had a documented hernia on examination. Conclusions Ultrasound imaging is commonly used to diagnose or confirm diagnosis of groin hernia in the primary care setting. This study was conducted during the COVID-19 pandemic; reduced access to face-to-face consultations may have resulted in increased use of imaging and absence of clinical examination in the assessment of these patients. Patients with suspected hernia should be reviewed by a secondary care specialist prior to diagnostic imaging.