Abdominal wall and hernia ultrasound provides dynamic, real-time imaging of the abdominal wall layers and inguinal region to detect hernias, evaluate hernia contents, and identify other abdominal wall pathology. Unlike CT, ultrasound allows assessment during Valsalva maneuver, directly demonstrating hernia reducibility and content protrusion.
Sonographers evaluate inguinal hernias (indirect vs. direct based on relationship to the inferior epigastric vessels), femoral hernias, umbilical and periumbilical hernias, ventral and incisional hernias, and Spigelian hernias. Hernia contents — omentum, bowel loops, fat — are characterized and assessed for strangulation signs including absent vascularity or aperistalsis. Abdominal wall hematomas, desmoid tumors, and endometriosis implants are additional differential diagnoses evaluated.
Abdominal wall and hernia ultrasound is covered under the ARDMS Abdomen (AB) specialty within the RDMS. Sonographers performing this examination require familiarity with groin anatomy, transducer positioning for inguinal canal imaging, and dynamic maneuver technique. This application is commonly requested by general surgeons and emergency physicians in the evaluation of groin pain and acute abdominal wall presentations.