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The inter-observer reliability is very low at clinical examination of parastomal hernia
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
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2011 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 26, no 1, 89-95 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Parastomal hernia in patients with a permanent colostomy is common. The aim of this study was to evaluate the reliability of the diagnosis based on clinical examination and to compare this examination with the result of a specially designed questionnaire and computerised tomography (CT) scan. METHODS: Forty-one patients operated upon with an abdominoperineal resection due to rectal cancer at three hospitals between 1996 and 2002 were included. At minimum of 4 years after the operation, they underwent clinical examination by two or three independent surgeons, answered a colostomy questionnaire and were offered a CT scan of the abdominal wall. RESULT: At Hospital I, 17 patients were examined by three surgeons, with inter-observer kappa values between 0.35 and 0.64. At Hospital II, 13 patients were examined by three surgeons, the kappa values ranged between 0.29 and 0.43. At Hospital III, 11 patients were examined by two surgeons, with kappa value of 0.73. The kappa value between CT scan and the colostomy questionnaire was 0.45. CONCLUSION: The inter-observer reliability was low, indicating that parastomal hernia is difficult to diagnose by patient history and clinical examination. Some herniae may not be detected by CT scan, and the correlation to patient-reported complaints is low. A more sensitive radiological method to detect parastomal hernia is needed.

Place, publisher, year, edition, pages
2011. Vol. 26, no 1, 89-95 p.
Keyword [en]
CT scan, Hernia, Inter-observer, Parastomal, Reliability
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-139472DOI: 10.1007/s00384-010-1050-2ISI: 000285785600011PubMedID: 20821218OAI: oai:DiVA.org:uu-139472DiVA: diva2:381378
Available from: 2010-12-27 Created: 2010-12-27 Last updated: 2017-12-11Bibliographically approved

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Gurmu, AmbatchewNilsson, SvenPåhlman, LarsGunnarsson, Ulf

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