Superior mesenteric vein thrombosis complicating gangrenous appendicitis

Superior mesenteric vein [SMV] thrombosis is a condition of uncommon occurrence the diagnosis of which is challenging as the patient usually presents with nonspecific symptoms. Early diagnosis with computerized tomographic [CT] abdominal scan can prevent progression to mesenteric infarction. Herein, a case of SMV thrombosis secondary to gangrenous appendicitis is reported. Early intervention in the patient with full anticoagulation, helped to resolve the condition with no surgical intervention

Efficacy of local anaesthesia and simplicity of mesh plug technique in open inguinal hernia repair in patients above 60 years of age

Local anesthesia offers several advantages over other types of anesthesia because it is limited to a small body area. This study evaluates the efficacy of local anesthesia arid the simplicity of the Mesh Plug technique in open inguinal hernia repair, particularly in patients over the age of 60 years. A prospective study was conducted on 150 patients above the age of 60 who were admitted to a specialized hernia clinic in the Armed Forces Hospital, Southern Region, Saudi Arabia. They underwent inguinal hernia repair using the Mesh Plug technique under local anesthesia as a day surgery procedure. The mean age was 69 years. Concomitant diseases were present in 60 [40%] patients. Local anesthesia was used in 144 [96%] patients. Operative time, hospital stay and the postoperative analgesic requirement were recorded. The postoperative pain was evaluated for the first eight hours using the Wong/Baker face scale. The mean hospital stay was 0.6 day [range 8 hours - 7 days], 138 patients were discharged after eight hours from the day surgery unit, while 12 patients stayed between 1-7 days. The mean operative time starting from local anesthesia infiltration was 36 minutes [range 30-50 minutes]. Local complications were reported in 39 men, 18 [12%] had bruising, 18 [12%] had a seroma and three [2%] had neuralgia. Neither infection nor recurrence was recorded during the period under review. Local anesthesia and the Mesh Plug technique in inguinal hernia repair is a safe and effective procedure in elderly patients. Age and concomitant diseases should not be a contraindication to elective hernia repair