E4599. All About Abdominal Hernias: A Primer for Residents
  1. Nicholas Balanda; Rush University Medical Center
  2. Pokhraj Suthar; Rush University Medical Center
  3. Sumeet Virmani; Rush University Medical Center
Abdominal Hernia is one of the commonest incidental findings seen in imaging studies. As a radiologist, is important to know different types of abdominal hernias based on location (external, internal, or diaphragmatic), with early recognition of complications. This case-based multi-modality pictorial review provides an overview of abdominal anatomy, hernia types, and complications depicted across multiple imaging modalities.

Educational Goals / Teaching Points
To display a case-based multi-modality pictorial review of hernias including abdominal, groin, pelvic, diaphragmatic, and various internal hernias. Define hernia, review epidemiology. Highlight the importance of early diagnosis and treatment of hernias. Identify hernia type and location, contents, and muscle and fascial integrity. Identify neighboring anatomy and assessment of risk – (e.g. compression of vascular structures by femoral hernias). Identify hernia complications and post-surgical complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
1. Anatomy of hernias: Abdominal: Umbilical, paraumbilical, Incisional, Epigastric, Parastomal, Lumbar, Spigelian, Richter, port site, Rectus sheath. Groin: Inguinal (direct, indirect, and pantaloon), Femoral. Pelvic: Obturator, Perineal, Sciatic. Diaphragmatic: Bochdalek, Hiatus, Morgagni. Various Internal Hernias. 2. Complications: Incarceration, strangulation, bowel obstruction, and necrosis. 3. Post-surgical complications: Seroma, Abscess, Mesh infection, “Plugoma”, “Meshoma”, local inflammation at the surgical site.

Prompt identification of hernias enables assessment of risk and determination of the necessity and route of treatment. Exposure to the breadth of presentations of abdominal hernia on various imaging modalities aids the radiologist in prompt recognition and accurate assessment of hernias and their complications.