Abstract
Complications related to inguinal hernias are commonly encountered in medicine. Clinical presentation can vary, and although diagnosis can often be made during physical examination, point‐of‐care ultrasound (POCUS) can be useful in cases where the diagnosis is unclear. Our case underscores to clinicians the utility of POCUS in diagnosing inguinal hernias.
Short abstract
Complications related to inguinal hernias are commonly encountered in medicine. Clinical presentation can vary, and although diagnosis can often be made during physical examination, point‐of‐care ultrasound (POCUS) can be useful in cases where the diagnosis is unclear. Our case underscores to clinicians the utility of POCUS in diagnosing inguinal hernias.
1. CLINICAL QUESTION
How are inguinal hernias typically diagnosed? What is the preferred imaging modality?
2. CASE
A 36‐year‐old man with history of intravenous heroin use presented with altered mental status, acute respiratory failure, and a distended scrotum. Point‐of‐care ultrasound showed multiple actively peristalsing loops of bowel in the left inguinalcanal and hemiscrotum, consistent with a massive scrotal inguinal hernia (Video S1). He was treated for lung empyema and scheduled for hernia repair. Complications from inguinal hernias are commonly encountered in medicine. 1 Although typically diagnosed on physical examination, our case highlights the underappreciated role of point‐of‐care ultrasonography in diagnosing inguinal hernias, especially during critical illness, if the diagnosis is unclear, or complications are suspected. 2
AUTHOR CONTRIBUTIONS
PAT designed manuscript, acquired data, drafted and revised article, and approved final version of the manuscript. JP designed manuscript, interpreted data, drafted and revised article, and approved final version of the manuscript.
FUNDING INFORMATION
No financial support was used for this manuscript.
CONFLICT OF INTEREST
The authors have no financial, consultant, institutional, or other conflicts of interest to declare.
ETHICS STATEMENT
This case report was exempt from institutional review board approval since de‐identified patient information was used.
CONSENT
Written and verbal informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Supporting information
Video S1
Video Caption
ACKNOWLEDGMENT
None.
Twohig PA, Pile JC. Peristalsis in an unusual place—The diagnostic utility of point‐of‐care ultrasound: A case report. Clin Case Rep. 2022;10:e06768. doi: 10.1002/ccr3.6768
DATA AVAILABILITY STATEMENT
No data are available.
REFERENCES
- 1. Brooks DC, Hawn M. (2018). Classification, clinical features and diagnosis of inguinal and femoral hernias in adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. Accessed November 12, 2021. https://www.uptodate.com/contents/classification‐clinical‐features‐and‐diagnosis‐of‐inguinal‐and‐femoral‐hernias‐in‐adults
- 2. Robinson A, Light D, Kasim A, Nice C. A systematic review and meta‐analysis of the role of radiology in the diagnosis of occult inguinal hernia. Surg Endosc. 2013;27(1):11‐18. [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Video S1
Video Caption
Data Availability Statement
No data are available.