PT  - JOURNAL ARTICLE
AU  - Wang, Tao
AU  - Vajpeyi, Rajkumar
TI  - Hernia sacs: is histological examination necessary?
AID  - 10.1136/jclinpath-2013-201734
DP  - 2013 Dec 01
TA  - Journal of Clinical Pathology
PG  - 1084--1086
VI  - 66
IP  - 12
4099  - http://jcp.bmj.com/content/66/12/1084.short
4100  - http://jcp.bmj.com/content/66/12/1084.full
SO  - J Clin Pathol2013 Dec 01; 66
AB  - The hernia sac is a common surgical pathology specimen which can occasionally yield unexpected diagnoses. The College of American Pathologists recommends microscopic examination of abdominal hernias, but leaves submission of inguinal hernias for histology to the discretion of the pathologist. To validate this approach at a tertiary care centre, we retrospectively reviewed 1426 hernia sacs derived from inguinal, femoral and abdominal wall hernias. The majority of pathologies noted were known to the clinician, including herniated bowel, lipomas and omentum. A malignancy was noted in three of 800 inguinal hernias and seven of 576 abdominal wall hernias; five of these lesions were not seen on gross examination. Other interesting findings in hernia sacs included appendices, endometriosis, a perivascular epithelioid cell tumour, and pseudomyxoma peritoneii. All hernia sacs should be examined grossly as most pathologies are grossly visible. The decision to submit inguinal hernias for histology may be left to the discretion of the pathologist, but abdominal and femoral hernias should be submitted for histology.