The inguinal darn.

We performed 115 nylon darn repairs in 100 patients with inguinal hernia; 61 were primary and 54 secondary repairs, with 50 patients in each group. The Kinmonth modification of the Moloney darn was used. Thirty-seven percent of secondary repairs were done in patients with two or more previous repairs. Thirteen patients had indirect hernia repairs. The follow-up on 105 repairs in 90 patients averaged 62 months. There were two (3.5%) primary and four (8.3%) secondary repair recurrences. The six failures (5.7%) overall were either technical errors or improper patient selection. Three superficial wound infections (2.6%) healed without complications or suture sinuses. The inguinal darn for recurrent inguinal hernias appears to have a lower recurrence rate than the reported 15% to 30% following other techniques.

Fragmentation of a Celestin tube causing intestinal obstruction. Case report and review of the literature.

Current management of benign and malignant esophageal lesions has changed little in the past 25 years. Treatment of unresectable lesions has consisted primarily of exclusion and bypass procedures as well as prosthetic intubations for relief of dysphagia. A case of a Celestin tube fragmentation in a patient with unresectable esophageal carcinoma causing small bowel obstruction is presented. Diagnosis, management, and review of the literature are discussed. Recommendations for use of the Celestin tube in patients with good long-term prognoses include keeping a high index of suspicion for possible complications, close and regular radiographic and endoscopic follow-up, and early surgical intervention upon tube fragmentation.