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Sonographic Imaging and Anterior Abdominal Wall Hernias
Table 2: Types of hernia description and sonographic report among study population
Sonographic report
Hernia types Frequency Normal Cholelithiasis Abdominal mass p
Umbilical hernia N 58 44 8 6 >0.001
% 64.4 75.8 13.8 10.34
Epigastric hernia N 20 13 4 3 0.035
% 22.2 65 20 15
Ventral hernia N 10 2 2 6 0.202
% 11.1 20 20 60
Spigelian hernia N 2 2 — — —
% 2.2 100 — —
p, using Chi-square test

all the patients, the results about gender prevalence showed higher hernia, 39 patients (50%) had metabolic syndrome, and eight
prevalence in women compared to the previous studies (with a 6:1 patients (10.2%) had both umbilical hernia and metabolic syndrome.
ratio). Epigastric hernias are prevalently detected in elderly men than in This study again emphasized the role of metabolic syndrome as
women with a 3:1 ratio; however, our research showed different results a risk factor for gallstone formation. At the same time, the study
regarding epigastric hernia. In our population, the epigastric hernia results showed that the prevalence of umbilical hernia is higher in
was 1.5 times more prevalent in women. Ventral hernias occur after cholelithiasis patients. The last two studies predicted the common
abdominal incisions, and small incisions are preventing factors of this risk factors of umbilical hernia and cholelithiasis, and our results were
hernia type. Risk factors for a ventral hernia include age, malnutrition, similar to them so that there was the coexistence of cholelithiasis
ascites, diabetes, obesity, smoking, long-term corticosteroid use, sepsis among 13.8% of umbilical hernia patients. 8,9
after surgery, wound infections, and emergency surgeries. 1
Nevertheless, our study showed different results; if technical conclusIon
mistakes or the risks as mentioned above are absent, there is an Emphasizing the results of our study, the probable coexistence
80% association between ventral hernias and intra-abdominal of surgically treatable intra-abdominal disease with the same
surgically treatable diseases. Spigelian hernia is observed near the symptoms is not negligible in the patients with anterior abdominal
arcuate line exactly lateral to rectus abdominis muscle. Because of wall hernias. Therefore, it is recommended to perform total
its complex regional anatomy, the diagnosis of Spigelian hernia is abdominopelvic sonographic examination on patients with these
accompanied by challenges. In our study, only 2.2% of the population hernias before their herniorrhaphies.
had Spigelian hernia, confirming the challenging diagnosis of this
type of hernia according to texts. Another aspect of our research
was related to the coexistence of intra-abdominal surgically treatable AcknowledgMents
diseases. As a prevalent intra-abdominal disease, cholelithiasis has All members of the surgery department in the Urmia University of
common risk factors with anterior abdominal wall hernias. There Medical Sciences were cordially available to answer our questions.
are two main pathophysiologic factors for anterior abdominal wall We would also like to thank the experts from other universities
hernias: First, any factor elevating intra-abdominal pressure such as who were involved in the validation of the survey for this research.
obesity, pregnancy, ascites, bowel obstruction, and intra-peritoneal
dialysis; and second, structural and functional weakness of anterior references
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