CT-detected inguinal and femoral hernias in women: prevalence and interobserver agreement.
- 1Programa de Radiología e Imágenes Diagnósticas, Fundación Universitaria Sanitas, Bogotá, Colombia.
- 2Departamento de Radiología e Imágenes Diagnósticas, Colsanitas, Bogotá D.C., Colombia.
Abstract
Background
Inguinal and femoral hernias in women show a reported diagnostic gap, with systematic evidence supported by cohorts composed of approximately 84% men.Materials and methods
We conducted a descriptive, retrospective, cross-sectional observational study at a reference center in Bogotá during the 2024-2025 period. We included 494 women, 18 years or older, who had undergone abdominal computed tomography. Double reading by residents was applied, with 2-of-3 majority adjudication between the resident and two independent expert reviewers. Statistical analysis included 95% Wilson confidence intervals, Cohen's kappa with Landis-Koch interpretation, and sensitivity, specificity, positive predictive value, and negative predictive value, reported in accordance with STROBE guidelines.Results
Resident-diagnosed prevalence was 88 of 494 (17.8%; 95% CI 14.7-21.4). Adjudicated prevalence was 83 of 494 (16.8%; 95% CI 13.8-20.4). Five cases (1.0%) were reclassified as extraperitoneal fat by expert consensus. Findings included indirect inguinal predominance, bilateral distribution in 26.1%, a high proportion of occult hernias, and underreporting in the original radiology report. Resident sensitivity was 100% against both expert reviewers. Specificity was 84.4% against Reviewer 1 and 47.4% against Reviewer 2. Cohen's kappa for resident vs. Reviewer 1 was 0.878; resident vs. Reviewer 2 was 0.326; and Reviewer 1 vs. Reviewer 2 was 0.408.Conclusions
The radiological prevalence in women sits above the classical clinical range. Extraperitoneal fat is an overlooked differential diagnosis in female cohorts and accounts for a large part of interreviewer discordance. The 2-of-3 rule works as a replicable method for diagnostic studies with limited resources.
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BibTeX
@article{milanes2026ctdetected,
title = {{CT-detected inguinal and femoral hernias in women: prevalence and interobserver agreement.}},
author = {Sara Gómez Milanés and Oreanna Quintero Rojas and Jaime Martínez and Fernando Ortiz and Andrés Felipe González Serna},
journal = {Frontiers in radiology},
year = {2026},
month = oct,
doi = {10.3389/fradi.2026.1957651},
url = {https://europepmc.org/article/MED/42948617},
note = {CC BY},
}
RIS
TY - JOUR
TI - CT-detected inguinal and femoral hernias in women: prevalence and interobserver agreement.
AU - Sara Gómez Milanés
AU - Oreanna Quintero Rojas
AU - Jaime Martínez
AU - Fernando Ortiz
AU - Andrés Felipe González Serna
PY - 2026
DA - 2026/10/13
JO - Frontiers in radiology
DO - 10.3389/fradi.2026.1957651
UR - https://europepmc.org/article/MED/42948617
AB - Background Inguinal and femoral hernias in women show a reported diagnostic gap, with systematic evidence supported by cohorts composed of approximately 84% men.Materials and methods We conducted a descriptive, retrospective, cross-sectional observational study at a reference center in Bogotá during the 2024-2025 period. We included 494 women, 18 years or older, who had undergone abdominal computed tomography. Double reading by residents was applied, with 2-of-3 majority adjudication between the resident and two independent expert reviewers. Statistical analysis included 95% Wilson confidence intervals, Cohen's kappa with Landis-Koch interpretation, and sensitivity, specificity, positive predictive value, and negative predictive value, reported in accordance with STROBE guidelines.Results Resident-diagnosed prevalence was 88 of 494 (17.8%; 95% CI 14.7-21.4). Adjudicated prevalence was 83 of 494 (16.8%; 95% CI 13.8-20.4). Five cases (1.0%) were reclassified as extraperitoneal fat by expert consensus. Findings included indirect inguinal predominance, bilateral distribution in 26.1%, a high proportion of occult hernias, and underreporting in the original radiology report. Resident sensitivity was 100% against both expert reviewers. Specificity was 84.4% against Reviewer 1 and 47.4% against Reviewer 2. Cohen's kappa for resident vs. Reviewer 1 was 0.878; resident vs. Reviewer 2 was 0.326; and Reviewer 1 vs. Reviewer 2 was 0.408.Conclusions The radiological prevalence in women sits above the classical clinical range. Extraperitoneal fat is an overlooked differential diagnosis in female cohorts and accounts for a large part of interreviewer discordance. The 2-of-3 rule works as a replicable method for diagnostic studies with limited resources.
SN - 2673-8740
ER -