Features of diagnostic approaches to Gilmore’s groin
Background. Gilmore’s groin is a disease whose morphological substrate is structurally anatomical changes in the elements of the inguinal canal without the formation of a real (true) groin. Accuracy of the diagnosis becomes especially important when solving the problem of effective surgical treatment of this category of patients and provides the development of a specific program of diagnostic search — a diagnostic algorithm. The purpose was to develop a consistent program of diagnostic algorithm for patients with Gilmore’s groin. Materials and methods. A comparison of clinical signs was performed in two groups of patients: the first (main) one included 47 patients with Gilmore’s groin; the second (comparative) one — 20 individuals with inguinal groin. Both groups of patients were comparable in terms of age, sex, and duration of the disease. Informativity was determined by calculating the sensitivity, specificity and diagnostic efficiency. Results. The most significant indicators among the general diagnostic tests were the following: 1) the presence of pain and discomfort in the inguinal area; 2) pain in the inguinal area that increases on movements; 3) pain in the inguinal area during palpation in conditions of tension of the anterior abdominal wall; 4) enlargement of the external inguinal ring; 5) cough pain test. For the purpose of final verification of the diagnosis and evaluation of structural and anatomical violations of the inguinal area, ultrasonography and magnetic resonance imaging were used. The implementation of the proposed diagnostic approach has contributed to an increase in the diagnostic accuracy up to 98 %. Conclusions. Gilmore’s groin is a rare disease that requires a reliable diagnosis and adequate surgical treatment. The diagnostic approach developed on the basis of objective assessment of the informativity of the special clinical signs with the addition, if necessary, of ultrasonographic and computed tomography scans, contributes to an increase in the diagnostic accuracy up to 98 %.
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