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

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Abstract
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.