Internal Hernia Through a Congenital Defect in Broad Ligament: A Rare and Elusive Cause of Intestinal Obstruction.

Internal hernias through a defect in the broad ligament is an uncommon cause of intestinal obstruction and most often the finding is intra-operative. What makes it rare is when the hernia occurs through a congenital defect in the broad ligament. We present the case of a 48-year-old female patient operated on an emergency basis for intestinal obstruction and intra-operatively the cause was identified to be a herniated ileal loop through a defect in the broad ligament. There was no history of any prior abdominal surgery or any interventions and all of her children were born by normal vaginal delivery, making it a case of congenital broad ligament defect. The postoperative period was uneventful and she was discharged in good health.

Role of Omega-3 Fatty Acid Infusion in Surgical Outcomes of Perforation Peritonitis Patients: A Randomized Controlled Trial.

Background Perforation peritonitis is associated with a high rate of morbidity and mortality in spite of advances in antibiotics and surgical techniques. The Omega-3 fatty acid is an immune-enhancing essential fatty acid that has been found to have anti-inflammatory properties, which help in quicker recovery. The present study examined the role of Omega-3 fatty acid infusion in the surgical outcome of perforation peritonitis. Methods Three hundred consecutive patients in the age group of 18-70 years operated for perforation peritonitis were included in this study. Patients in the study group received Omega-3 fatty acid emulsion postoperatively while those in the control group received a placebo. The groups were compared with respect to clinical and biochemical parameters. Results The Omega-3 fatty acid helped in reducing postoperative complications. The incidence of postoperative pyrexia (22.67% versus 82.67%), chest infection (6% versus 31.33%), and complete wound dehiscence (12% versus 34%) was significantly less in the study group compared to the control group. There was a 4.5-day difference in overall length of stay, favoring the study group who were on Omega-3 fatty acids (LOS 8.06 vs. 12.65 days). There was no mortality in the study group compared with 17 deaths (11.3%) in the control group. Conclusion Postoperative perforation peritonitis patients receiving Omega-3 fatty acids are at a lower risk of developing postoperative complications, have a shorter duration of hospital stay, and have lower morbidity and mortality.