The Modified Iliopubic Tract Repair-A Pain-Free Alternative.

Background The open preperitoneal repair offers the benefits of placing the mesh in the preferred position while avoiding the disadvantages of laparoscopic repair. Methods A total of 60 patients with bilateral inguinal hernias were randomized to undergo either the standard Lichtenstein meshplasty or the modified iliopubic tract repair in a teaching hospital. Outcomes measured were immediate postoperative pain, return to activity, and delayed neurological complications. Results Patients who underwent the iliopubic tract repair walked out of bed faster than the Lichtenstein group (6.3 hours vs 7.4 hours, p < 0.0001) and experienced significant lower pain as charted by visual analogue scale scores (3.28 vs 2.71 on day 1, 2.16 vs 1.71 on day 2, 1.92 vs 1.08 on day 3; p < 0.05). Delayed complications like chronic inguinal pain and numbness were not seen in the iliopubic tract group. However, this difference was not statistically significant ( p > 0.05). Conclusion The iliopubic tract repair offers an excellent alternative to the Lichtenstein meshplasty, and is associated with lower postoperative pain, earlier return to work, and lower delayed neurological complications.

Delayed Presentation of Isolated Jejunal Perforation Following Accidental Trauma.

Blunt abdominal trauma can injure any abdominal organs which had significant morbidity and mortality in paediatric age group. It can lead to duodenal, jejunal or rather any bowel perforation. Isolated jejunal perforation still remains rare entity with less documented reports in specifically paediatric age group. We hereby present a case of three-year-old female child with isolated jejunal perforation, post history of fall from height. Early exploration and prompt surgical intervention led to successful outcome in this patient.