Left Amyand’s hernia with inflamed appendix and sealed of perforated caecum an unusual case

Amyand’s hernia is defined as the hernia with appendix normal, inflamed or perforated as content. 1% of inguinal hernias are Amyand’s and amongst them 0.1% contains inflamed appendix. Commonly encountered on right size due to anatomical position of appendix. Left Amyand’s is rare and associated with intestinal malrotation, situs invertus and mobile caecum. Here, we presented an interesting case of left irreducible hernia in 70 years old gentleman with no signs of acute obstruction or strangulation, patient underwent emergency laparotomy in which hernial sac contents were inflamed ileal loop, inflamed appendix and perforated caecum in 70 years old man is rare presentation and not reported in any literature as per our knowledge. Resection of inflamed bowel loop with ceacum done along with ileo ascending anastomosis with primary tissue repair done. Post-operative period was uneventful. Hernia sac contents are most of the time surprising and their management sometimes differ according to the content. Appendix in hernia sac is found in 1% of all hernia but lack of facility for the pre-operative diagnosis and varied presentation it is challenging to diagnose and operate accordingly.

A study of clinical analysis and management of lnguinoscrotal swelling in paediatric age group

Background: Inguinoscrotal swellings are one of the commonest congenital problems in infancy and childhood. Delay in diagnosis and treatment leads to loss of testis, ovaries or portion of bowel to incarceration or strangulation. This study was undertaken for clinical evaluation of age, sex, sidewise distribution management and management of complications.Methods: Retrospective observational study done from April 2011 to March 2019. Children with age from 1 month to 12 years presenting with inguinoscrotal swelling Results: In Total 174 children had inguinoscrotal swelling which include 155 (89%) male children and 19 (11%) female children. Most of the patients presented in 2 to 5 years (41%) age group out of 114 case of inguinal hernia include 63 on right,47 on left and 4 bilateral and 60 case of hydrocele 48 on right,10 on left and 2 bilateral.0ut of 174 children 16 were discharge on same day of surgery. Out of 174 children 1 patient had taken as emergency operation due to irreducible hernia. Conclusions: Inguinal hernia and hydrocele in children remain one of the most common congenital problems observed by surgeons. The childhood inguinoscrotal swellings are generally more predominant on the right side and this has been attributed to the delay in descent of the right testis. Regarding the sex prevalence, males are more commonly affected. Inguinal herniotomy in children is a safe and effective operation done as day care procedure.

Irreducible Hernia in Female Children Containing Ovary, Uterus or Uterine Adnexa: Case Series

Inguinal hernias are the most frequent hernias of childhood. They are relatively uncommon in females as compared to males. Congenital inguinal hernias are due to the failure of closure of processus vaginalis. In females, this usually obliterates around the eighth month of foetal life. When these remain patent, a rare but possible herniation of contents can occur through this, like the genito-urinary system, including the ovaries and sometimes the fallopian tubes. However, the occurrence of uterus as one of the contents is a rare entity. This is a case series of six such cases with various genital tract entities as contents in paediatric female inguinal hernia. In conclusion, the rare entity of uterus, uterine adnexae and ovaries being a content of inguinal hernia has to be kept in mind when treating female children.

Incidence of Inguinal Herniotomy in Children. A Prospective Study at a Regional Hospital

Background: Inguinal hernia is one of the most common surgical conditions in children. Herniotomy is the surgery performed for a pediatric hernia and hydrocele. This study was done to know the demography and outcome of pediatric herniotomy at our center. Materials and methods: A prospective study on patients who underwent herniotomy from 10th May 2016 to 9th May 2017 was conducted at the Department of Surgery, Western Regional Hospital. Results: During this study 112 patients underwent herniotomy out of which 98 were boys while 14 were girls. 59(52.67%) patients had unilateral hernia, 40(35.71%) had unilateral hydrocele and 13(11.6%) had bilateral condition among which 8 had hernia and 5 had hydrocele. 69(61.6%) patients presented with a right-sided, 30(26.7%) with left-sided, and 13(11.6%) with bilateral conditions. 13 patients (11.6%) presented at the emergency with irreducible hernia. Two among the patient who underwent emergency herniotomy developed postoperative wound infection and one among the elective surgery had recurrence. Conclusion: Pediatric inguinal hernias and hydroceles are often difficult to diagnose clinically. Herniotomy is often performed by junior consultants who have no specific training in pediatric surgery. Timely planning of surgery is required to minimize preoperative complications.

Study of contents of inguinal hernia in girls

Background: Inguinal hernia in females is relatively uncommon as compared to males. In female patients, the hernial sac contains one ovary in approximately 15–20% of cases, and some also contain a fallopian tube. This study was done to know the contents in inguinal hernia in girls.Methods: A prospective study on eight girls with inguinal hernia presenting between January 2016 to December 2018, presented with swelling in inguinal region. Physical examination in all girls was done followed by ultrasonogram to know the content of inguinal hernia. All patients underwent surgical exploration.Results: Among 8 girls with inguinal hernia, 2 (25%) girls had bilateral inguinal hernia, 4(50%) girls had right and 2 (25%) girls had left sided inguinal hernia. Ultrasonogram showed 2 girls with bilateral inguinal hernia had intestines as content on both sides. 3 girls had intestines, one (10%) girl had omentum and 2 (20%) girls had ovary as content of hernia sac. On surgical exploration one girl had omentum, one had ovary, two had intestine as hernial sac content. Two girls with irreducible hernia had omentum and ovary respectively as hernial content. In all girls after reduction of content, herniotomy was done.Conclusions: Surgical repair should be done at diagnosis in all girls presenting with inguinal hernia in view of high incidence of incarceration of ovary and tubes. Sac must be opened and its contents examined before it is tied off and excised.