CLINICAL ACUMEN IN DIFFERENTIATION OF DIRECT AND INDIRECT INGUINAL HERNIA IN ADULTS.

J Peop Univ Med Health Sci. 2025:15(2), 126-132. http://doi.org/10.46536/jpumhs/2025/15.02.632

Abstract

BACKGROUND: Inguinal hernia is a frequent case to come across in the outpatient clinic as well as in emergency. OBJECTIVE: To determine the diagnostic accuracy of clinical acumen in differentiating indirect from direct inguinal hernia in adult population by keeping surgery-open inguinal hernia repair (tension-free with mesh/Lichtenstein or by reconstruction of the floor with tissue)- as gold standard. PLACE AND DURATION OF STUDY: This cross sectional study was executed at department of General Surgery, Liaquat University of Medical & Health Sciences, Jamshoro. The duration of the study from 01/01/2023 to 31/12/2023 for one year. PATIENTS AND METHOD: This cross sectional study was executed at department of General Surgery, Liaquat University of Medical & Health Sciences, Jamshoro. The duration of the study was from 01/01/2023 to 31/12/2023. On surgery, position of hernia will be noted and direct or indirect hernia will be confirmed through the scrotum towards the external inguinal (as per operational definition). All this information will be recorded on pro-forma (attached). RESULTS: For this study the mean age of the patients was 45.42±15.33 years, 68(68%) and they were married. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of clinical findings were 89.36%, 79.25%, 79.25%, 89.36% & 84% respectively taking surgical findings as gold standard. CONCLUSION: According to this study we may conclude that clinical acumen has good diagnostic accuracy in differentiating indirect from direct inguinal hernia in adult population by keeping surgery as gold standard.