Procedure (cont.)

9. Briefly fluoroscope during injection of the contrast agent to detect and avoid inadvertent injection into the abdominal wall or into a hollow viscus (bowel or bladder).

10. Manually reduce all hernias to avoid nonfilling of a hernial sac.

11. Place the patient upright for 2-3 minutes and encourage him/her to cry or cough to increase intraabdominal pressure.

12. Take PA films of the inguinal area at 5 minutes and 10 minutes with the patient prone and the table tilted 30° feet down. To distinguish a patent processus vaginalis or indirect inguinal hernia from a femoral hernia, 45° oblique views are recommended also.

13. If the patient has a groin bulge but the earlier films are show no abnormality, a delayed film at 45 minutes will ocassionally show a communicating hydrocele and usually demonstrates a urogram, if information about the upper urinary tract is desired.