Choosing Wisely: Don't Use Ultrasound to Evaluate Palpable Inguinal Hernia

By the Editors

The Society of American Gastrointestinal and Endoscopic Surgeons has released a set of medical practices that should be questioned as part of the Choosing Wisely campaign.

Among the advice relevant to primary care clinicians:

• For patients presenting with suspected gallstone disease, imaging tests other than ultrasound should not be used in the initial evaluation.

• For patients with a clearly palpable inguinal hernia, ultrasound should not be routinely used in the evaluation.

• For pain control after surgery, opioid-only modalities should be avoided. Nonopioid medications and locoregional anesthetic blocks should be used if feasible.