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Invited Commentary
January 2016

Computed Tomographic Imaging in the Diagnosis of Recurrent Ventral Hernia

Author Affiliations
  • 1Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Surg. 2016;151(1):13-14. doi:10.1001/jamasurg.2015.2587

Ventral hernias (VHs) are common in the United States, with more than 350 000 repairs performed annually.1 Nevertheless, consensus regarding the optimal technique for VH repair is lacking and recurrence rates remain high (approaching 50% in some series), suggesting we are not quite ready to close the book on VH management.

Considerable debate persists in VH management, particularly in cases of recurrence. Although the treatment of symptomatic recurrence detected on physical examination is usually surgical repair, management dilemmas arise for symptomatic patients without palpable hernias and asymptomatic patients with detectable hernias. In these settings, computed tomography (CT) as an adjunct to physical examination may be beneficial. Although data suggest CT may be superior to examination, especially for obese patients or small hernias, no standardized criteria for diagnosis of recurrent herniation exist.2,3

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