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Keywords:
Hernia, Education and training, Economics, Diagnostic procedure, Image manipulation / Reconstruction, CT, Stomach (incl. Oesophagus), Colon, Abdomen
Authors:
M. Revelli, L. Bacigalupo, F. Paparo, M. Furnari, D. Astengo, C. Conforti, G. A. Rollandi; Genoa/IT
DOI:
10.1594/ecr2015/C-0465
Results
No statistical significant differences were found among the groups enrolled in terms of demographic and epidemiological characteristics (Table 1).
A sliding hiatal hernia was present in 51% (102/200) of the patients belonging to the CT-WE cohort and in 48.5% (97/200) of the patients in the CTC group.
In CT-WE patients,
hernia size was reported as small in 82.4% (84/102) of patients,
moderate in 12.7% (13/102),
and large in 4.9% (5/102).
In CTC patients,
hernia size was categorized as small in 79.4% (77/97) of patients,
moderate in 14.4% (14/97),
and large in 6.2% (6/97).
Internal control abdominal CT of the 31 subjects with a hernia at CT-WE showed absence (i.e.
resolution) of the hernia in 58.1% (18/31) of patients (Figure 1),
including 76.5% (13/17) and 45.5% (5/11) of small and moderate hernias,
respectively.
None of the 3 large hernias among the internal control patients at CT-WE was absent at comparison abdominal CT,
and the routine CT compared with CT-WE showed a reduction in hernia dimension in 7 additional patients.
Using these findings to evaluate the CT-WE cohort we assumed that 23.5% of small hernias,
54.5% of moderate hernias and 100% of large hernias would have been present without colonic distention associated to CT-WE.
In the 28 patients with a HH at CTC the comparison abdominal CT,
used as internal control,
showed absence (i.e.
resolution) of the hernia in 57.1% (16/28) patients (Figure 2),
including 68.8% (11/16) and 50% (5/10) of small and moderate hernias,
respectively.
None of the 2 large hernias among the internal control subjects at CTC was absent at comparison abdominal CT and the routine CT compared with CTC showed a hernia down-sizing in additional 4 patients: using these findings to evaluate the CTC cohort,
we considered that 31.2% of small hernias,
50% of moderate hernias and 100% of large hernias would have been present without colonic distention associated with CTC.
Normal 0 14 false false false IT JA X-NONE
The prevalence of sliding hiatal hernias in the external control group was 22% (44/200),
significantly lower than the CT-WE and CTC cohorts’ prevalence of 51% (p < 0.0001) and 48.5% (p < 0.0001),
respectively.
These hernias were small-sized in 77.3% (34/44),
moderate-sized in 13.6% (6/44) and large-sized in 9.1% (4/44),
as showed in Table 1.
After applying the correction factors for the CT-WE and the CTC groups,
the estimated residual prevalences (16% and 18.5%,
respectively) were much closer to that of the external control patients (p = 0.160 for CT-WE and p = 0.455 for CTC),
as showed in Table 2.
There was no statistical significant difference in terms of dimension of the HH between gas-induced and water-induced distention.