Diagnostic ultrasound ( PDFDrive )

CHAPTER 13 Dynamic Ultrasound of Hernias of the Groin and Anterior Abdominal Wall 501
B
A
C
D
E
FIG. 13.63 Entities That Simulate Groin Hernia. (A)
Hydrocele in canal of Nuck (inguinal canal). See also Video
13.23. (B) Varices. Round ligament varices. (C) Endometrioma.
(D) Inguinal lipoma. (E) Labial lipoma. Transverse view of
isoechoic lipoma of the left labium majus in patient with painless
swelling of the left labium.
wall aponeuroses or muscle sheaths. Desmoids are locally invasive
and tend to recur if not excised widely enough, but do not
metastasize distantly. Sonographically, desmoids are solid nodules
or masses that are irregular in shape and have some internal
vascularity (see Figs. 13.64B). Desmoids are diicult to distinguish
from sarcomas, except for slightly less blood low on color or
power Doppler ultrasound. If not excised, desmoids grow progressively.
Benign and malignant connective tissue tumors of the
anterior abdominal wall such as ibromas (see Fig. 13.64C) and
ibrosarcomas (see Fig. 13.64D) can simulate anterior abdominal
wall hernias.
SUMMARY
Dynamic ultrasound is the key examination for assessing groin
or anterior abdominal wall pain. Dynamic components of the