To analyze the diagnostic value of multi-slice spiral computed tomography (MSCT) and color high-frequency ultrasound for early complications in patients undergoing open tension-free inguinal hernia repair.

A total of 168 patients who underwent open tension-free inguinal hernia repair in Wuxi Xinwu District Xinrui Hospital from January 2021 to February 2025 and developed adverse symptoms in the early postoperative period were selected as the research objects. All enrolled patients were diagnosed with either MSCT or color high-frequency ultrasound. During the diagnosis, the examination position and technique were adjusted according to the individual clinical condition of each patient, and multi-sectional exploration was performed to ensure comprehensive sonographic images were obtained. After the diagnosis, radiologists were responsible for identifying and interpreting the ultrasound scan images.

MSCT achieved a coincidence rate of 100.00% in detecting periprosthetic effusion, which was significantly higher than that of color high-frequency ultrasound (66.67%), while its coincidence rate for fat liquefaction was 63.16%, significantly lower than that of color high-frequency ultrasound (94.74%) (P<0.05). MSCT diagnosed 131 cases as positive, 37 cases as negative, with 6 misdiagnosed cases and 8 missed cases; color high-frequency ultrasound diagnosed 132 cases as positive, 36 cases as negative, with 11 misdiagnosed cases and 12 missed cases. The κ value (0.753) and Youden index (0.768) of MSCT for early postoperative complications were higher than those of color high-frequency ultrasound (0.589 and 0.596, respectively).

MSCT and color high- frequency ultrasound have similar overall diagnostic efficacy for early complications in patients undergoing open tension-free inguinal hernia repair. However, MSCT demonstrates superior diagnostic consistency and comprehensive practical value, with advantages in detecting periprosthetic effusion, while color high- frequency ultrasound is more targeted in detecting fat liquefaction.