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Article
A Comparison of Bupivacaine Instillation and Ultrasound Guided Field Block for Post-Operative Pain Relief in Inguinal Hernia Repair

Author: Iyad Abbas Salman* , Ali Moayed Jwad
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 3 Pages: 248-251
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: Postoperative pain is a common problem after inguinal hernia repair. Postoperative pain may delay the return to normal activity and delay hospital discharge. Various techniques have been employed to provide postoperative analgesia, by the use of regional anesthetic technique, local anesthesia or traditional analgesic technique: opiates, non-steroidal anti-inflammatory drugs (NSAIDs) or combinations.OBJECTIVE: To compare the postoperative pain relief provided by simple bupivacaine wound instillation and ultrasound guided inguinal hernia field block.PATIENT AND METHOD: A single blind, prospective, randomized controlled clinical trial for 72 male patients who were undergoing elective unilateral inguinal hernia repair. In 37 of them 10 ml of 0.5% plain bupivacaine was instilled (irrigated) into the wound by the surgeon for 1 minute. In another 35 patients, ultrasound guided field block performed using 20 ml of 0.25% plain bupivacaine at the end of surgery. Vital signs, numerical pain score and analgesia requirement were recorded at recovery (zero hour), 1st, 2nd, 4th& 8th hours postoperatively.RESULT: By applying null hypothesis, using the t-student test of two independent samples, pain score and request for analgesia show significant difference only at the first two hours with p-value <0.05, otherwise there was no significant differences in the following hours. For vital signs there was no significant difference for both groupsCONCLUSION: Bupivacaine instillation is as effective as ultrasound guided field block for inguinal hernia repair pain. We recommend this technique in places where ultrasound machine is not available especially in many developing countries.


Article
THE CLINICAL UTILITY OF LAPAROSCOPY IN THE MANAGEMENT OF IMPALPABLE TESTES IN PEDIATRIC AGE GROUP
الفائدة السريرية لناظور البطن فى علاج الخصي الغير محسوسة عند الاطفال

Author: MUSLIM L. ALABDULLAH مصلح عبداللة
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2013 Volume: 7 Issue: 2 Pages: 1-8
Publisher: University of Dohuk جامعة دهوك

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Background Laparoscopy is proposed to play a major role in the management of impalpable testes in pediatrics. The Objectives of the study is to assess the role of laparascopy in the management of impalpable testes.Methods A prospective study for 49 impalpable testes (46 patients) in which three patients had bilateral impalpable testes. All of these patients underwent diagnostic laparoscope in the Pediatric Surgery Center at Al-Khansaa Teaching Hospital from the period between July 2008 and January 2012. All these patients were proved to have impalpable testes whether unilateral or bilateral by clinical examination.Results Five testes (10.2%) were palpated after anesthesia so traditional orchiopexy were performed. These patients were excluded from the study. Eleven (25%) from the remaining 44 testes were vanished. 33(75%) testes were identified intraabdominally at different sites, Ten (22.7%) were near the internal inguinal ring and directly fixed, Eleven (25%) were fixed after extensive release of the cord, Seven (15.9%) fixed after cutting the testicular vessels, and Five (11.3%) after staged surgery and these were discharged home a day after surgery.There were no intra operative and immediate post laparoscopic complications. Follow up from six months to two years showed that the testes were located in a normal scrotal position, but four (9%) were smaller than the contralateral ones.Conclusions The laparoscopic management of impalpable testes is the most useful method with excellent results and low morbidity. Moreover, it is quick and easy in dealing with all varieties of impalpable testes.

الخلفية والأهداف: ناظور البطن يفترض انه يلعب دور مهم في علاج الخصية الغير محسوسة عند الاطفال. الهدف من البحث هو تَقييم استخدام ناظور البطن لعلاج الخصية الغير محسوسة.طرق البحث: دراسة مستقبلية ل 49 خصية غير محسوسة (46 مريض) حيث انه كان هنالك ثلاثة مرضى مصابين بخصية غير محسوسة متناظرة. اجريت عملية الناظور التشخيصي لجميع المرضى في مركزِ جراحةِ الأطفال في مستشفى الخنساء التعليمي بالموصل للفترة بين تموز 2008 وكانون الثاني 2012. لقد تم اثبات ان جميع الاطفال كان لديهم خصى غير محسوسة سواء كانت بجهة واحدة او متناظرة عن طريق الفحص السريري.النتائج: خمسة خصى (10,2%) تم إحساسها بعد التخدير واجري لهم تثبيت مباشر. تم استبعاد هوْلاء المرضى من البحث. احدى عشر (25%) كانت متلاشية ، وثلاثة وثلاثون خصية (75%) كانت موجودة في التجويف ألبطني في مواقع مختلفة حيث انه عشرة خصى (22,7%) كانت مستقرة قرب المحبس الداخلي الاربيي فثبتت مباشرة ، احدى عشر (25%) ثبتت بعد تحرير واسع ، سبعة (15,9%) ثبتت بعد قص أوعية الخصية وخمسة (11,3%) احتاجوا عملية متدرجة وهوْلاء المرضى الذين اجري لهم ناظور البطن اخرجوا من المستشفى في اليوم التالي.لا توجد أي مضاعفات أثناء أو بعد عملية الناظور مباشرة. بعد متابعة تراوحت بين ستة اشهر و سنتين كان جميع الخصى في موقع طبيعي في كيس الصفن ماعدا أربعة (9%) كانوا اصغر من نظائرهم.الاستنتاجات: يعتبر ناظور البطن طريقة مهمة لتشخيص ومعالجة الخصية الغير محسوسة بجميع مواقعها وهو سريع وسهل التعامل مع نتائج ممتازة و قلة المضاعفات.


Article
Mesh repair versus non mesh repair of primaryinguinal hernia

Authors: Othman A.Salim --- Salem A. Al-Sarraf --- Safa M. Al-Obaidi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 4 Pages: 403-406
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Techniques of Inguinal hernia repair have seen an evolution from the pure tissue repair to the prosthetic repair and in the recent years past to laparoscopic repair. High recurrence rates using fascia for the hernia repair or the use of sutures under tension prompted the development of polypropylene mesh to reinforce the posterior wall of the inguinal canal.The aim of this study is to compare the post operative results of Lichtenstein mesh technique with Dar ning repair.
Patients and methods:-A prospective study of "100" patients with inguinal hernia were conducted to evaluate two methods, of open repair of inguinal hernia Lichtenstein mesh technique with Traditional non-mesh technique (modified Bassini or Darning).Operation were done under general, epidural and local anaesthesia at the surgical units of Baghdad Teaching Hospital and Arbil Teaching Hospital.
Results: The study showed that Lichtenstein mesh technique is an effective operation for repair of inguinal hernia with low complication rate and less pain in comparison to the repair by traditional non-mesh technique. Also the results show that, mesh repair group returned to work earlier than non-mesh repair group.
Conclusion:Mesh repair of primary inguinal hernia repair is superior to non-mesh repair in term of early postoperative pain , return to the work and recurrence.


Article
Repair of inguinal hernia under local anaesthesia in high risk patient

Author: Dr. Naseer K. Jawad Al Maleky
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2010 Volume: 13 Issue: 2 Pages: 146-151
Publisher: University of Kufa جامعة الكوفة

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Abstract

Inguinal hernia repair is a common operation in general surgery and can be performed under local, regional or general anaesthesia, The American Society of Anaesthesiologists (ASA) 3 and 4 patients are generally considered unsuitable for day case hernia repair, high risk for surgery under general or regional anaesthesia, so we study surgery under local anaesthesia for those high risk group.Aim: Aim of our study were to look at the high risk patient suitability for day-case repair of inguinal hernia under local anaesthesia(LA).Patient and method: Between January 2007 and January 2009, 75 patients with unilateral inguinal hernia ASA 3 and 4 underwent prospective study for repair of hernia under local anaesthesia by plug and patch of mesh.Result: 75 patients with inguinal hernia were operated on under local anaesthesia, median age 68 (range 40 to 102) years, 29 direct type, 43 indirect type ,3 direct and indirect type (pantaloon type) , the median body weight 53kg (ranged 45 to 105 kg).The duration of procedures were 30 to 80 minutes ( average 50 minutes ) .3 of cases with big irreducible hernia perioperatively required IV diazepam 5 mg and one of them requires IV pethedine 50mg, 1 patient developed superficial wound infection, 3 patients developed subcutaneous seroma, 9 patients had ecchymosis at site of infiltration and operation, 3 patients developed scrotal haematoma , no one develop urinary retention ,and no recurrence during follow up period and no mortality. The median period of follow up 6 months (range 4- 15 months) ,Waiting time for our study 1 to 2 week compared to patient required GA 2-3 months.Conclusions: Repair of inguinal hernia under LA in high risk patient seems to be safe and feasible with an acceptable morbidity. Obesity in itself is not an absolute contra-indication for LA and the waiting times are acceptable and can be done as day case surgery.

ان عمليات الفتق المغبني من اكثر عمليات الجراحه العامه ومن الممكن ان تجرى تحت النخدير العام او الموضعي والمرضى ذوي الحالات الخطره صنف 3 و 4 وفق الجمعيه الامريكيه للتخديربصوره عامه غير مؤهلين للعمليات تحت التخدير العام,ولكن الصورة تختلف اذا اجريت العمليه تحت التخدير الموضعي لذى قمنا بدراسه حول استخدام التخدير الموضعي للمرضى ذوي الحالات الخطرهالهدف : دراسه مدى فعاليه استخدام التخديرالموضعي في الحالات الخطره للمصابين بالفتوقات المغبنيه وإمكانية اجراها كعمليه جراحيه يوميه.المرضى وطرق العمل : منذ شهر كانون الثاني 2007 الى كانون الثاني 2009 ,75 مريض مصابون بفتوقات مغبنيه ومصنفين كحالات خطره من حيث التخدير صنف 3 و 4 وتمت العمليات تحت التخدير الموضعي و باستخدام الشبكه في رتق الفتوقاتالنتائج : 75 مريض معدل اعمارهم 68 سنه (29 فتق مغبني نوع مباشر و 43 غير مباشر و 3 النوعين معا) ومعدل اوزانهم 53 كغم و متوسط وقت العمليه 50 دقيقه 3 من الحالات من نوع الفتوقات الكبيره غير الراجعه احتجنا الى استخدام 50 ملغم من الديازيبام بالوريد وحاله واحده احتجنا الى البثدين 50 ملغم .حاله واحده اصيبت بالتهاب سطحي في جرح العمليه و3 حالات اصبن بتجمع سوائل مصليه تحت الجلد و 3 حالات اصيبوا بتجمع دموي في كيس الصفن و 9 حالات نزف تحت الجلد لا توجد حالات من انحباس الادرار او رجوع الفتق او الوفات و الوقت الانتظار للعمليه 1-2 اسبوع مقارنه للعمليات تحت التخدير العام من 2 الى 3 شهر.وجدنا ان هذه الطريقه امينه وذات مشاكل مقبوله حتى في حالة المرضى ذوي الاوزان الثقيله ويمكن اجراءها كجراحه يوميه ويتم اخراج المريض في نفس اليوم الذي تمت فيه.


Article
Analysis of Open Tension Free (Mesh plug and patch) Inguinal Hernia Repair
دراسه تحليليه لعملـــــــية رتق الفتق المغبني المفتوحـــــه بالشــــبكه(الســـد ّاد و الرقعـــــه)الخاليه من الشــَـــد

Author: Amer Hassan Salman د.عامر حسن سلمان
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2011 Volume: 24 Issue: 2 Pages: 138-146
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Inguinal hernia repair is the most frequent operation in general surgery. Until recently the standard has been open musculo-aponeurotic repair using sutures under tension to close the defect, but tension-free repair using prosthetic mesh is becoming increasingly common and considered the standard procedure. Many procedures have been used but still the most effective surgical technique is unknown. Objective: Assessment of open tension free (Mesh plug and patch) inguinal hernia repair regarding early return to normal activity, postoperative pain, complications and recurrence rate.Methods: A prospective study of (73) patients with inguinal hernia operated upon, in Al- Yarmouk Teaching Hospital (from Oct. 2005 to Oct. 2009) using the technique of open tension-free inguinal hernia repair (plug and mesh). The data was collected in the proforma designed for the study. The operative time, severity of post operative pain and analgesia, hospital stay, early mobilization, early and late complications and early return to activity, were all assessed.Results: The operative time was (36 minutes), there is mild postoperative pain that relieved by short term analgesia, and the time for return to activity was after (3-7days) and this was in 59 (95%) patients, and the time interval before carrying out the most strenuous activity was 14 days and it was in 42 (91.3%) patients out of 46 employed patients. There was mild scrotal swelling, Hematoma in 4(6.5%) patients, mild Seroma in one (1.6%) patient, surgical site infection (SSI) in 3(4.8%) patients, no one required surgical interference, one patient (1.6%) had groin hyperesthesia and one patient developed mild swelling relieved after 30 days. There is no recurrence and no chronic disabling pain.Conclusion: Using open mesh plug and patch inguinal hernia repair showed reduced post operative pain, early rehabilitation, early discharge (6 -24 hours) and early return to activity ( after one week) and no recurrence In comparison to other studies using the other open technique, this method looks to be superior to conventional tension repair of inguinal hernia in term of rehabilitation, early return to activity and recurrence. Key words: Inguinal hernia, open mesh plug and patch, repair

الهــــــدف: تقييم عملية رتق الفتق المغبني المفتوحه بالشــــبكه (الســــداد والرقــــــعه) الخاليه من الشــــَد , وسرعةالرجوع الى النشـــــــاطات الطبيعيه من بعد العملــــــــيه ,والم مابعد العمليه, والمضاعفات والفتق الراجع0الطريقــــــه: دراسه مستقبليــــــه ل 73 مريض أجريت لهم عملية رتق الفتق المغبني المفتوحه بالشــــبكه (الســــداد والرقــــــعه) الخاليه من الشــــَد , في قسم الجراحـــــه في مستشفى اليرموك التعليمي خلال (2005-2009) جمعت المعلومات في استماره خصصت للدراسة حيث تمت متابعة مابعد العملـــــيه في الاسبوع الاول والثاني والرابع وبعدها شهريا ً, تم فيها ملاحظـــــــــة(الوقت الذي إستغرقته العمليه , وشدة الالم بعد العمليه , والأدويـــــه المســّـــكنه والمضادات الحياتيه , وفترة البقاء في المستشفى , وعقابيل العمليه القريبه والبعيدة الأمـــد).النتــــــائج: كان الوقت المســــــتغرق اثناء العمليه بمعدل(36)دقيقه، كانت فترة النقاهــــــه قصيره والرجوع الى النشاط الطبيعي بعد (3-7)ايام من العمليه وكان هذا في 59(95%)مريضاً،وكان الرجوع الى الأعمال الشديده ،هي 14 يوماً حيث تمكن42 (91%)مريضا ً من الرجوع الى اعمالهم السابقه. لوحـَظ الم بسيط في العمليه تم علاجه بمسكنات لفترة قصيرة ،ولوحظ تورم بسيط في كيس الصفن عند 4(6,5%) مريض وتجمع بلازمي عند مريض واحد (1,6%)والتهاب سطحي لجرح العمليه عند 3 (4,8%) لم يحتاجوا الى تداخل جراحي و خدر في المنطقه المغبنيه عند مريض واحد (1,6%) وانتفاخ في العمليه عند مريض واحد(1,6%)ولم نلاحظ رجوع للفتق ولم نحصل على مرضى يعانون من الالم المزمن.الإســــــتنــــتاج:عملـــــية رتق الفتق المغبني المفتوحه بالشــــــبكه(الســــــد ّاد والرقعـــــــه)اظهروا الما ً بسيطا ًمابعد العمليه وســــرعه في النقاهــــــه والخروج من المستشفى المبكر (6-24) ساعه,وسرعة الرجوع الى النشاط الطبيعي (3-7)ايام بعد العمليه وبالمقارنه مع دراســــات اخرى استعملت طرق اخرى لإجراء العمليه تبين إن هذه الطريـــــــقه هي أرقى من العمليه التقليديه لرتق الفتق المغبني مقارنة ًفي سرعة النقاهه ومعــــاودة النشاط الطبيعي وعدم رجوع الفتق.


Article
Amblyopia Therapy in Older Children

Author: Furkaan Majied Hamied
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2012 Volume: 8 Issue: 14 Pages: 26-31
Publisher: Al-Qadisiyah University جامعة القادسية

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Amblyopia (lazy eye) is a common problem affecting 1-5% of children, it is a unilateral or bilateral reduction of best corrected visual acuity that cannot be attributed directly to any structural abnormality of the eye or the posterior visual pathway. A prospective study of tow years done on thirty child all of them older than seven years age presented with uni or bilateral amlyopia; visual acuity, ocular motility, Hurshberg taste, slit lump biomicroscopy, fundoscopy, and cycloplegic refraction, treatment with correction of the refractive error, full time occlusion, part time occlusion, and penalization according to the severity.Most of children gets an improvement in there visual acuity Most of new studies in amblyopia in agreement with our results, while the old opinion limiting the critical period at 6-7 years old. So we should try for treatment of amblyopia in older children while giving a full explanation to the child's family about the poorer results of treatment, for medico legal purposes.

العين الكسوله أو الخاملة هي مشكله شائعة تصيب 1-5% من الأطفال, أنها ضعف البصر بالرغم من تصحيح الأخطاء الأنكساريه في عين واحده أو في كلتا العنين الذي لا يمكن نسبه بصوره مباشره الى أي مشكله عضويه في العين أو المسار البصري الخلفي. دراسه مستقبليه أجريت على ثلاثون طفل يعانون من مشكلة العين الكسولة أعمارهم تتراوح بين السبعة والعشرةسنوات,.أجري لهم الفحص المجهري وفحص قاع العينين والذي نتج عنه عدم وجود أي خطأ عضوي يذكر, في حين نتج عن قياس الأخطاء الأنكساريه فوجد أنهم يعانون من بعد البصر, قصر البصر مع أو بدون حول؛ بعد العلاج بتصحيح الخطأ الأنكساري بالعوينات مع غلق كامل, غلق جزئي, أو تشويش الرؤيا في العين السائدة مع المتابعة لسنتين فوجد أن معظم الأطفال تحسنت درجة رؤياهم. بالتوافق مع نتائج معظم البحوث المجراة على العين الكسولة تبين أنه يمكن علاج الأطفال الأكبر عمراً, عكس الرأي القديم؛ أن نهاية الفترة الحرجة هي 6-7سنوات. لذلك لا بد من محاولة علاج الأطفال الأكبر سنا بعد التوضيح لذويهم عن ضعف النتائج وذلك للأغراض الطبية الشرعية.


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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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.


Article
Amyand's Hernia in a 9-Month-Old Infant: Case Report & Review of the Literature

Author: Ali Egab Joda* ,Nawzat Hussein
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 2 Pages: 218-223
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: Amyand’s hernia is defined as the presence of an appendix inside the sac of inguinal hernia whether inflamed or not, it is very rare occurring in less than 1% of patients of inguinal hernia surgery. Although it was first described three centuries ago in an 11-year-old boy by Claudius Amyand, it still continues to possess some fuzziness regarding its diagnosis & treatment because of the scarcity of its occurrence. It has variable clinical presentation according to the extent of appendix inflammation & related complications. The diagnosis of an Amyand's hernia is difficult to settled clinically. However, imaging studies are beneficial for both diagnosis and recognition of the associated complications. Here, we report a case of Amyand's hernia in a 9-month-old male infant discovered incidentally during surgery for right sided inguinal hernia in the department of pediatric surgery in the Central Child Teaching Hospital in Baghdad in which we did reduction of a normal appendix into abdominal cavity & herniotomy with high up transfixation of hernia sac.The purpose of presenting this case report is the rare occurrence of Amyand's hernia & the possibility of encountering an unusual content of hernia sac during the repair of inguinal hernia, that is why Amyand's hernia should be taken in consideration while operating on obstructed or strangulated inguinal hernia. The surgeon need to be aware of all clinical presentations with which the Amyand's hernia may present and the suitable, individualized option of surgical treatment applied. In this paper we review the literature on presentation of Amyand's hernia and discuss the diagnostic modalities with the current options of its surgical treatment.


Article
Inguinal hernioplasty by darning versus prosthetic mesh
رأب الفتق الإربي بواسطة الترتيق مقابل عيون اصطناعية

Author: Ayoub M Zedan ايوب محمد
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2009 Volume: 1 Issue: 151 Pages: 158-162
Publisher: Tikrit University جامعة تكريت

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Abstract

To compare two tension free techniques, darning versus mesh repair in cases of inguinal hernia. Prospective study was done in Tikrit Teaching Hospital. Ninety-six patients with non-obstructive unilateral reducible and primary inguinal hernia 48 patients operate with mesh and other 48 patients operate with darn repair. The two techniques where compared with respect to effectiveness, post-operative complications, and recurrence rate. Over all post operative complications were 27.1%, 31.3% in darn group and mesh group respectively. In darn group, wound infection occurs in 8.3%, scrotal haematoma in 12.5%, urine retention in 4.2%, and nerve pareses 2.1%. In mesh group, wound infection occurs in 22.9%, scrotal haematoma 8.3%, no recurrence observed in both study groups in one year follow up. As a conclusion; Darn repair is equally effective and much less costly treatment for inguinal hernia than mesh repair which had more risk of infection

للمقارنة بين تقنيات التوتر 2 مجانا، رتقه مقابل تصليح شبكة في حالات الفتق الإربي. وقد تم دراسة استطلاعية في مستشفى تكريت. ست وتسعون المرضى الذين يعانون من عدم العرقلة من جانب واحد، واختزال الفتق الإربي الابتدائية 48 مريضا تعمل مع المرضى وغيرها من 48 شبكة تعمل مع إصلاح الرتق. الطريقتين حيث مقارنة فيما يتعلق فعالية، ومضاعفات ما بعد الجراحة، ومعدل تكرار. أكثر من المضاعفات بعد العملية وكانت جميع 27.1٪، 31.3٪ في مجموعة الرتق، ومجموعة عيون على التوالي. في مجموعة الرتق، عدوى الجرح يحدث في 8.3٪، ورم دموي صفني في 12.5٪، واحتباس البول في 4.2٪، وعصب pareses 2.1٪. في مجموعة شبكة، عدوى الجرح يحدث في 22.9٪، ورم دموي صفني 8.3٪، أي تكرار لوحظ في كل من مجموعات الدراسة في عام واحد متابعة. وختاما، إصلاح الرتق هو نفس القدر من الفعالية ومكلفة أقل بكثير لعلاج الفتق الإربي من إصلاح شبكة الذي كان أكثر عرضة للإصابة

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