INTRODUCTION: Ventral hernia is a challenging surgical problem. Occult ventral hernia defects contribute to the relatively high recurrence rate after open surgical repair.
METHODS: 44 patients underwent comprehensive physical examination, CT scan, and laparoscopy for ventral hernia. Hernia defects were mapped using all three methods and the results were compared. Descriptive statistics were used to analyze the difference between the three methods.
RESULTS: There are statistically significant difference between the number of defects found on physical examination and that found by ct scan or laparoscopic examination (p-value=0.0057 and 0.019 respectively). Physical examination was the least accurate method missing about 30% of the actual defects. CT scan and laparoscopy are similarly accurate with CT scan being better in finding distant defects while laparoscopy was more accurate in finding near defects.
CONCLUSION: In patients with ventral hernia, depending on physical examination alone may be misleading and can be associated with high recurrence rate. CT scan should be considered prior to surgical repair to ensure that all abdominal wall defects are found and correctly managed.
Program Number: P339