Role of Ultrasonography in the Preoperative Diagnosis of Inguinal Hernia at Nnamdi Azikiwe University Teaching Hospital

Inguinal hernia is one of the most common surgical conditions managed globally, yet clinical examination alone is sometimes insufficient for accurate preoperative diagnosis, particularly in obese patients or those with atypical presentations. This study evaluates the diagnostic accuracy of ultrasonography in confirming inguinal hernia prior to surgical repair at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Awka, Anambra State, South East Nigeria. A prospective diagnostic accuracy study was conducted among 130 patients referred for inguinal hernia repair from 2021 to 2024. Each patient underwent both clinical examination and preoperative ultrasound, with intraoperative findings serving as the reference standard. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Ultrasonography demonstrated a sensitivity of 91% and specificity of 88% for inguinal hernia detection, outperforming clinical examination alone, which had a sensitivity of 83%. Occult hernias not detected on clinical examination were confirmed by ultrasound in 11 cases. The study supports incorporating routine preoperative ultrasonography into hernia evaluation pathways at NAUTH and similar teaching hospitals in the South East. Training radiologists and sonographers in musculoskeletal ultrasonography is recommended to enhance diagnostic infrastructure. Keywords: inguinal hernia, ultrasonography, diagnosis, NAUTH Awka, preoperative assessment