Joseph Michael Miller MD, MS, Presenter: Nothing to Disclose

Shirin Towfigh MD, Abstract Co-Author: Nothing to Disclose

Rola Saouaf MD, Abstract Co-Author: Nothing to Disclose

Modern hernia repair involves placement of mesh within the inguinal canal. Mesh repairs are associated with more complications than primary tissue repairs and can often lead to a chronic pain syndrome known as inguinodynia. Diagnosis benefits considerably from cross-sectional imaging, however our internal data show that radiologists perform this task poorly. We conducted a retrospective review of 322 patients presenting to a specialty hernia surgeon from 2008-2013. Of the 56 patients with history of inguinal mesh, we identified 19 patients operated on for mesh-related complication with pre-operative cross-sectional imaging available. Radiologists only correctly reported mesh-related abnormalities in 32% of cases (compared to 79% success rate by a blinded expert reader, p = 0.0081). Evaluation of the post-operative groin is difficult. In addition to reviewing the CT and MRI findings of these surgically-confirmed complications, we intend to highlight the frequent causes of misdiagnosis found in our series. Relying on intraoperative correlation, we hope to illustrate the relevant devices and techniques involved in modern herniorrhaphy.

Techniques - Anterior repair - Pre-peritoneal repair  Devices - Flat Mesh - Sandwich - Plugs Complications - Malpositioning - Migration - Meshoma - Infection - Neuroma

http://abstract.rsna.org/uploads/2014/14007466/14007466_54gf.pdf

Miller, J, Towfigh, S, Saouaf, R, Beyond Recurrence: Recognizing the Pathologies of the Post-operative Groin.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007466.html