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June 4, 1997

Clinical Crossroads: A 65-Year-Old Man With an Inguinal Hernia-Reply

Author Affiliations

Cornell University Medical College New York, NY

JAMA. 1997;277(21):1679. doi:10.1001/jama.1997.03540450035023

In Reply.  —Dr Hamlin is correct in pointing out that herniography may be an useful method of demonstrating groin hernias when they are otherwise undetectable. I included this technique in early drafts of Clinical Crossroads, but removed it from the text on the request of a surgical peer reviewer who alleged, I believe correctly, that herniography was so infrequently done in North America that it should not be cited. This imaging technique was first popularized in Sweden.1 I do not deny the importance of herniography and believe that for completeness' sake it should have been included along with the other radiologic techniques, none of which is frequently done. For the record, I have used herniography only once—on which occasion the patient disliked it.Dr Vander Veer's points are well taken. Patients about to undergo a groin hernioplasty should have a history taken and physical examination. However, only those laboratory studies needed