Significance of ultrasonography in the assessment of patients with a groin mass: a large, single-center case series.

Abstract

There is a concern that the differential diagnosis of a groin mass depends on a physicians' subjective judgment and experience. We aimed to clarify the significance of US in the diagnosis of a groin mass. This retrospective study included 1,898 patients who underwent US examination of a groin mass. Physicians' diagnoses were compared with US-based diagnoses. Furthermore, the incidence of asymptomatic contralateral hernia was analyzed. The frequency of unnecessary surgery in patients with and without preoperative US was compared. In 1,451 patients who underwent surgery with preoperative US, the preoperative US classification was compared with surgical diagnosis. Of 1,805 patients diagnosed with an inguinal hernia by physicians, 190 (10.5%) exhibited no US findings of inguinal hernia. US revealed asymptomatic contralateral hernia in 13.3% of the 1,543 patients in whom a physician detected unilateral inguinal hernia. The frequency of unnecessary surgery was significantly associated with preoperative US (1/1451; 0% vs. 2/351, 0.6%; p=0.0382). The overall US diagnostic accuracy for the inguinal hernia type was 92.7%. US imaging of a groin mass can help avoid unnecessary surgery, detect latent inguinal hernia, and guide surgical planning.