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Abdominal Wall Hernias: Imaging Features, Complications, and Diagnostic Pitfalls at Multi–Detector Row CT¹

¹ From the Department of Radiology, University of California, San Diego, 200 W Arbor Dr, San Diego, CA 92103-8756 (D.A.A., A.C.S., G.C., C.B.S.); and the Fundación Sante Fe de Bogotá, University Hospital, Bogotá, Colombia (D.A.A.). Presented as an education exhibit at the 2004 RSNA Annual Meeting. Received February 3, 2005; revision requested March 7 and received April 5; accepted April 11. All authors have no financial relationships to disclose. Address correspondence to D.A.A. (e-mail: daguirre{at}ucsd.edu).

Abdominal wall hernias are a common imaging finding in the abdomen and may be complicated by strangulation, incarceration, or trauma. Because of the risk of developing complications, most abdominal wall hernias are surgically repaired, even if asymptomatic. However, post-surgical complications are also common and include hernia recurrence, infected and noninfected fluid collections, and complications related to prosthetic material. Multi–detector row computed tomography (CT) with its multiplanar capabilities is particularly useful for the evaluation of unrepaired and surgically repaired abdominal wall hernias. Multi–detector row CT provides exquisite anatomic detail of the abdominal wall, thereby allowing accurate identification of wall hernias and their contents, differentiation of hernias from other abdominal masses (tumors, hematomas, abscesses), and detection of pre- or postoperative complications. These findings improve the communication of imaging results to clinicians and help optimize treatment planning. Knowledge of multi–detector row CT findings in unrepaired and surgically repaired abdominal wall hernias and their complications is essential for making the correct diagnosis and may help guide clinical management.

© RSNA, 2005

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