Generalized peritonitis due perforated appendix in an Amyand's hernia: an unusual presentation of a rare condition

We report a 70 year-old male patient who had Amyand's hernia with an unusual clinical presentation. At surgery, the vermiform appendix was perforated and there was an abscess within the hernial sac associated with generalized peritonitis and multiple intra-abdominal abscesses. The preoperative differential diagnosis was incarcerated diaphragmatic hernia, colonic volvulus, or inguinal hernia associated with peritonitis. Although abdominal computed tomography successfully diagnosed the inguinal hernia, it could not demonstrate the appendix within its sac. As in the majority of published series, Amyand's hernia was discovered only intra-operatively. Through a midline laparotomy, the appendix remnants were excised and multiple intra-abdominal abscesses were evacuated. The patient had no postoperative complications and was discharged in a fair condition on the 8th postoperative day

Laparoscopic Vs open high ligation of the testicular veins for the treatment of varicocele

One hundred and ninety-three patients presented with varicocele were prospectively studied, 65 [group I] were treated by open high ligation of testicular veins, while the remaining 128 [group II] had laparoscopic varicocelectomy. All patients were randomly and prospectively selected. The disease was left sided in 95.4% and 85.2% as well as bilateral in 4.6% and 14.8% of cases in group I and II, respectively. In addition to varicocele ligation, 14 patients in group II had laparoscopy-assisted orchidopexy and 5 had laparoscopic repair of concomitant inguinal hernia. The mean hospital stay was 3.5 and 1.3 days and recurrence rates were 10.8% and 3.9%, respectively. Returning to normal activity was significantly earlier in group II compared with group I. There was no incidence of testicular atrophy in any case in the study whether testicular artery was ligated or preserved during surgery