Predictive factors of bowel resection due to an incarcerated groin hernia

Purpose In this retrospective study, we assessed factors that can be used to predict the need for bowel resection due to an incarcerated groin hernia. Methods We enrolled a total of 83 patients diagnosed with an incarcerated groin hernia on preoperative unenhanced computed tomography (CT) between January 2010 and December 2019 in our hospital. They were divided into two groups: those who underwent bowel resection and those who did not. The clinical findings, blood test results, and unenhanced CT values of patients were examined and compared between the two groups. The indication of intestinal resection was macroscopic necrosis or perforation of the incarcerated intestine. Results A total of 83 patients with incarcerated groin hernias were included in our study, of whom 13 (15.7%) had undergone bowel resection surgery. A univariate analysis identified a prolonged time from the symptom onset to surgery, increased white blood cell (WBC) count, increased C-reactive protein (CRP) level, decreased albumin level, and CT attenuation of the incarcerated intestinal wall at the fundus as significant predictive factors. The cut-off value for prediction of intestinal resection was 25 HU for the average CT attenuation of the incarcerated intestinal wall at the fundus and a WBC of 11,550 based on the receiver operating characteristic (ROC) curve. A multivariate analysis showed CT attenuation of the incarcerated intestinal wall at the fundus and an increased WBC count to be independent predictive factors. Conclusions Measuring unenhanced CT attenuation of the incarcerated intestinal wall at the fundus and the WBC count was suggested to be necessary for determining whether or not resection of the incarcerated intestine is required in cases of groin hernia.