[Comparison of complications of laparoscopic and open hernioplasty of inguinal hernia in Hamadan Beesat hospital]

Open and laparoscopic surgery are performed around the world to treat this condition. The aim of this study is to compare post operative complications of these two surgical methods. In this randomized clinical trial 100 patients with inguinal hernia were evaluated in two groups [open group A and laparoscopic surgery group B]. Patients were followed at 1 week and 3 months post-operatively to evaluate complications such as wound infection, edema, post-operative direct hernia, hydrocele, testicular atrophy and chronic pain. Data were statistically analyzed through chi square and t-tests. In open hernioplasty group [A] there were 46 males and 4 females and in laparoscopy group [B] 44 males and 6 females [P>0.05]. Mean age in hernioplasty group was 17.6 years and 16.3 years in laparoscopy group [P>0.05]. There were 4 mild, 2 moderate and 1 severe inflammation in group A and 1 mild and 1 moderate inflammation and none wound infections in group B [P>0.05], one week after surgery. There was no wound infection, testicular atrophy and post operative direct hernia in any of the groups. Three months after surgery 4 chronic pain cases were recorded in group A and 3 in group B. One patient with hydrocele was recorded in group B. [P>0.0]. The findings of this study showed that there were no statistically significant differences in post-operative complications between either laproscopic or open hernioplasty

[ case report of stercoraceous perforation of the cecum due to scybalum]

Non-traumatic colon perforations are usually caused by malignancy, diverticulum and colitis. Stercoraceous perforation of the colon has rarely been reported in the literature. This lesion is assumed to be produced by the pressure from a hard scybalum resulting in a perforated ulcer with necrotic edges. We report a case of stercoraceous perforation of the cecum due to scybalum. We report a 50-year-old man who had a severe abdominal pain from 3 days ago and had peritonitis in physical exam. He was admitted in Mars, 2005 at Mobasher Kashani Hospital in Hamadan and he was parapelegic from 8 months ago due to trauma in his medical history and then he had severe and chronic constipation that necessitated the use of cathartic drugs. We operated him with diagnosis of peritonitis, and perforation of cecum due to scybalum was seen and right hemicolectomy and colostomy and ileostomy was done. The most common site of colon perforation due to scybalum is rectosigmoid area and cecal perforation is a rare area in the literature. It is presented with peritonitis in old patients that have chronic constipation, it is difficult to diagnose this lesion preoperatively. This lesion was only 11% correctly diagnosed before operation and should be always suspected when a patient with chronic constipation suffers from sudden abdominal pain. Resection and colostomy is the treatment of choice in most situations