Marc Zins MD, Presenter: Nothing to Disclose

Nancy Silland, Abstract Co-Author: Nothing to Disclose

Marie Christine Julles, Abstract Co-Author: Nothing to Disclose

Isabelle Boulay-Coletta MD, Abstract Co-Author: Nothing to Disclose

Jerome Loriau, Abstract Co-Author: Nothing to Disclose

1.To describe a CT series of inguino-interstitial hernias (IIH) which form a group of very unusual inguinal hernias in which the hernial sac, instead of going downward, passes upward and outward and lays between the flat muscles of the abdominal wall, like in Spigelian hernias. 2. To determine specific CT features that help to distinguish IIH from Spigelian hernia.

In this IRB approved retrospective study, CT scans of 26 patients (14 men, 12 women; mean age: 58 years) with surgically proved IIH (n = 11) and Spigelian hernia (n = 15) have been reviewed. CT assessment included : 1) assessment of the hernial sac (anatomic situation, extension, content) and 2) assessment of the fascial defect (anatomic situation, distance to the origin of the inferior epigastric vessels).

In all cases (n = 26), the hernial sac was located between the internal and external oblique muscles. The fascial defect was located at the internal inguinal ring, lateral to the origin of the inferior epigastric vessels (mean distance: 5mm (0-12)) in the 11 cases of IIH and at the Spigelian aponeurosis, above the origin of the inferior epigastric vessels (mean distance: 38 mm(28-49)) in the 11 cases of Spigelian hernia.

Assessing only the hernial sac does not allow accurate classification of IIH from Spigelian hernia. Analysis of the topography of the parietal defect is essential in CT to distinguish Spigelian hernias from IIH, important informations for properly choosing the surgical approach.

Analysis of the topography of the parietal defect is crucial in CT to distinguish Spigelian from Inguino-interstitial hernias important informations for properly choosing the surgical approach.

Zins, M, Silland, N, Julles, M, Boulay-Coletta, I, Loriau, J, Inguino-Interstitial Hernia: A New Problem for Differentiation from Spigelian Hernia on CT.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8016085.html