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PEDIATRIC INGUINAL HERNIA IN BASRAH

Authors: Sadik H Kadhem --- Haithem H Ali --- Haider A Jassim
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Volume: 21 Issue: 2 Pages: 61-65
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract Inguinal hernia repair is one of the most frequently performed surgical procedure in pediatric patients. An inguinal hernia does not resolve spontaneously and must be repaired because of high risk of complications. The aim of this study is to determine epidemiologic index and complications of inguinal hernia in pediatric patients. This retrospective study was carried out in the Basrah Children Hospital. All patients who underwent surgeries for inguinal hernia from 2012 to 2014 were included in this study. Their hospital records were reviewed for age, sex, side of the hernia, presentation, wound infection, recurrence, and other complications. In this study, 877 children were included. 766 (87.3%) were boys and 111 (12.7%) were girls. Most common age of presentation is between 6 months to 6 years which compromise 54.6%. Right-side and left-side inguinal hernia was observed in 531 (60.5%) and 276 (31.5%) cases, respectively. Bilateral inguinal hernia was observed in 70 (8%) cases. One hundred forty eight (16.9%) children presented as emergencies with irreducible hernia. Emergency presentation was more in male gender and more in the first 6 months of life. Postoperative complication rate for elective was 3.2% and for emergency groups was 51.7%. In conclusion, most of the hernias involved male patients. Postoperative complications were observed in 51.7% of the emergency cases, so inguinal hernia in children should be operated as early as possible to avoid incarceration and to decrease post-operative complications.


Article
Spermatic Cord Lipomas: A Common Finding But A Subtle One

Authors: Majid Yas Khudhair --- Rafid Fakhir Hussein --- Mahmoud M. Al-Mukhtar
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 2 Pages: 526-530
Publisher: Babylon University جامعة بابل

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Abstract

True lipomas of the spermatic cord, as defined in surgical pathology textbooks, are rarely encountered during inguinal hernial surgical repair procedures. The most commonly encountered finding is a prolongation and/or extention of the retroperitoneal fat through the deep inguinal ring along or within the spermatic cord contents.This study tries to investigate the incidence, clinical significance and the best methods to predict the presence of the misnamed lipomas of the spermatic cord versus the true lipomas of the spermatic cord using classical open Lichtenstein and laparoscopic hernioplasty. A retrospective study of the records of (150) patients submitted to (160) surgical intervention for open/laparoscopic hernioplasty over a period of three years had been thoroughly investigated. Hernioplasty was conducted using laparoscopic total extraperitoneal (TEP) in (50 = 31.25%) cases while the remaining (110 = 68.75%) cases were managed using open Liechtenstein hernioplasty.The study showed that the ratio of indirect: direct inguinal hernia was (2.33:1). The proportion of right: left: bilateral inguinal hernias was (5.78:3.12:1). The incidence of spermatic cord lipomas was (20 = 12.5%) cases. Among these spermatic cord lipomas only (2 = 1.25%) cases were true lipomas in terms of surgical pathology. There is some difficulty in clinical diagnosis of these lipomas and it is easy to be misdiagnosed as cases of irreducible and/or obstructed inguinal hernias.Spermatic cord lipomas can cause symptoms similar to that of inguinal hernia with the absence of any associated hernial sac. It is easy to miss these lipomas when using laparoscopic hernioplasty especially when employing the procedure of (TAPP) with the persistence of the preoperative symptoms. Such postoperative complaints may constitute a source of problematic distress to the laparoscopic surgeon. Accordingly, surgeons should be aware of the possible co-existance of spermatic cord lipomas during any type of inguinal hernioplasty.


Article
Inguinal hernia repair under local anaesthesia

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Abstract

Background: For various reasons, inguinal hernia repair under local anaesthesia is not well accepted to both patients and surgeons. The patients fear from pain and surgeons need full relaxation and co-operation to do successful hernia repairMethods: purpose of this study is to evaluate the effectiveness of local anaesthesia in inguinal hernia repair.prospective study was made from January 2011-0ctober 2013 , on a total of 50 patients with inguinal hernia operated on under local anaesthesia. Patients were selected primarily on the basis of their willingness to accept the procedure after the technique was described to them.Results: In this study 50 patient and 58 herniorrhaphies done for them during a period of about 34months were evaluated .A questionnaire was sent to each patient postoperatively to aid in evaluating the subjective reactionto the local anaesthesia. all patients were males ,age range between 31-83 year, median age 51 .types of inguinal hernia were sliding 1case ,pantaloon 5cases ,indirect 28cases ,direct 24 cases ,Rt. Side 27cases, Lt. side 15 cases ,bilateral hernia 8 cases .we give local anesthesia by 2 methodsConclusions: Local anesthesia is without question the safest available technique of anesthesia.Local anesthesia is an extension of the surgical procedure (indeed, often an integral part of that procedure), and as such its administration should be the concern of the surgeon.

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