Using computed tomography imaging for the quantitative assessment of bowel viability in incarcerated groin hernia.

Abstract

Purpose: Rapid assessment of bowel viability in patients with incarcerated groin hernia (IGH) is crucial. However, there have been few studies on the quantitative indicators to assess bowel viability objectively. This study investigates the usefulness of the computed tomography (CT) value of the intestinal contents in this context.

Methods: The subjects of this retrospective study were 84 patients with IGH diagnosed at our hospital between April, 2011 and March, 2023. The patients were divided into two groups according to whether they had necrotic (n = 24) or non-necrotic (n = 60) IGH. We reviewed the clinic-radiological factors associated with bowel necrosis.

Results: The CT value of the incarcerated intestinal contents was significantly higher in the necrotic group than in the non-necrotic group (24.67 vs 9.33 HU, p < 0.001). Furthermore, multivariate logistic regression analysis identified the CT value of the incarcerated intestinal contents as an independent predictor of bowel necrosis (hazard ratio 275; 95% confidence interval 21.9-3450; p < 0.001).

Conclusions: The CT value of the incarcerated intestinal contents in IGH is a reliable and objective indicator for bowel viability preoperatively. This quantitative method of evaluation is effective and independent of clinical experience and can improve decision-making in the management of this condition.