Differentiation of Femoral and Inguinal Hernias on the Basis of Anteroposterior Relationship to the Inguinal Ligament on Multidimensional Computed Tomography

Purpose: The purpose of this study was to evaluate whether multidimensional computed tomography (MDCT) can be used to differentiate between types of groin hernias, specifically femoral and inguinal hernias, based on their anteroposterior relationship to the inguinal ligament. Materials and Methods: We retrospectively analyzed 75 groin hernias of 71 patients, including 28 femoral and 47 inguinal hernias. We diagnosed hernias prolapsing anterior to the inguinal ligament as inguinal hernias and those passing posterior to the ligament as femoral hernias. Results: In 74 of 75 cases, femoral and inguinal hernias were correctly differentiated from each other based on MDCT. In one case of a "sign of aggregation" of an inguinal hernia, the anteroposterior relationship to the inguinal ligament could not be evaluated because the hernia existed superior to the ligament. Conclusions: Femoral and inguinal hernias that extend caudal to the inguinal ligament can be differentiated based on their anteroposterior relationship to the inguinal ligament using MDCT.