Prevalence of aortic aneurysm in men with a history of inguinal hernia repair

Background: Population-based screening for abdominal aortic aneurysm (AAA) is still a subject of debate. This study examined whether subjects with a history of inguinal hernia were at increased risk sufficient to justify screening. Methods: The prevalence of AAA. was documented in 156 men aged 55 years and older, discharged after inguinal hernia surgery, and compared with the prevalence in 1771 men without a history of inguinal hernia who were participating in a screening survey for AAA. The influence of age and smoking status was assessed. Results: The prevalence of AAA in men with a history of inguinal hernia was 12.2 (95 per cent confidence interval (c.i.) 7.0-17.4) per cent and 3.7 (95 per cent c.i. 2.8-4.6) per cent in those without such a history; prevalence ratio 3.3 (95 per cent c.i. 2.0-5.3). In current smokers the prevalence of abdominal aneurysm was 4.2 (95 per cent c.i. 2.1-8.2) times higher in those with compared with those without a history of inguinal hernia. In non-smokers the prevalence ratio was 1.9 (95 per cent c.i. 0.5-7.0). Conclusion: Men with a history of inguinal hernia are at increased risk of AAA, most notably if they are cigarette smokers. Ultrasonographic screening could be considered before operation for inguinal hernia.