Comparative study between different methods in the treatment of traumatic colonic injuries in normal colon

Thirty two patients with traumatic colonic injury were collected from Ain Shams University Hospitals, Naser Institute Hospital and Al Helal Hospital. Associated injuries, length of operative procedure, wounding agent, length of hospital stay, method of treatment and Septic complications were evaluated. According to the Penetrating Abdominal Trauma Index [PATI] Fourteen patients were treated with colostomy at the site of injury, three with diverting colostomy proximal to repair site, fourteen with primary repair and one patient with exteriorization and early drop back. Primary repair was confinied to young adult patients with minimal fecal contamination, presented within 8 hours of injury which was caused by low velocity injury [stab wound], did not need blood transfusion and were haemodynamically stable. Overall septic morbidity was 7 out of 32 [22%] patients. No statistically significant difference was found in morbidity between colostomy 95 patients out of 17 [29%] and repair [3 patients out of 14-21%]. The only patient with exteriorization repair has no morbidity. No deaths were reported among the 32 patients studied. Sixteen out of the seventeen colostomies [93%] were later closed with morbidity in 3 patients out of 16 [18%]. The mean length of stay for Iry repair patients was 10.3+3.8 days, counting days for both initial and colostomy closure admissions [P < 0.05]. This study indicated that Iry repair doesn't carry an increased risk of septic complications in well chozen patients and saves the patient the significant risk and increased hospital stay of colostomy closure

role of high ligation operation in the management of subclinical varicocele as a cause of male infertility

Male infertility is due to variety of causes; perhaps the most common identifiable and correctable cause is the clinically obvious varicocele. Most varicoceles occur as a result of incompetent internal spermatic venous valves or collateral by pass of competent valves with resultant free reflux of venous blood into the pampiniform plexus [Belker 1981, Lawrence 1991]. Recently trials to study the subclinical varicocele and its relation to infertility with the aid of high resolution sonography was done to fourty eight-patients who were referred to us with the diagnosis of infertility, an abnormal semen analysis and a normal physical examination of the scrotum underwent sonography. The final study group who agreed to surgical high ligation of the spermatic veins after positive sonographic findings included 19 men. Sonography was considered positive for subclinical varicocele in 95% of patients. Post-operatively, all patients showed improvement in their semen analysis and 40% [8 patients] became fertile

Report on 16 cases of mesh repair for incisional hernia

Thirty two patients with incisional hernia were operated upon over a period of 4 years by mesh repair. These included 6 patients with incisional hernia following lower midline incision, 4 patients following supra umbilical midline incision, 3 patients following upper paramedian incision and 3 patients following lower paramedian incision. Out of these patients 7 were males and 9 were females. We used a merseline mesh inserted between the peritorneum the muscle layer. Respirtory function test was done to all patients to evaluate their need for postoperative ICU admission for 24 hours. Five patients had bad respiratory function test needed ICU care postoperatively. Follow up of patients for a period ranging from 9 months these to one year showed no actual recurrence