The repair of an inguinal hernia is one of the most common surgical procedures performed worldwide. Both Totally Extraperitoneal (TEP) and Transabdominal Preperitoneal (TAPP) laparoscopic techniques have emerged as competitive alternatives to open mesh repair. This study evaluated the outcomes of open inguinal hernia repair vs laparoscopic procedures. Materials and Procedures: One hundred patients with inguinal hernias were included in this prospective comparative analysis. They were split equally into groups for laparoscopic (n = 50) and open repair (n = 50). Assessments were made of surgical time, postoperative discomfort, complications, hospital stay, recurrence, recuperation, and patient satisfaction. Statistical analysis has been carried out using SPSS program; p<0.05 was considered significant. Results and Observations: Compared to the open group (45.6±10.7 min; p=0.002), the laparoscopic group's mean operating time was significantly greater (60.2±15.4 min). However, postoperative discomfort was much reduced with laparoscopic repair. The laparoscopic group returned to regular activities faster (7.5±2.1 days vs. 14.2±3.7 days; p=0.002) and had a shorter mean hospital stay (1.2±0.5 days vs. 2.8±0.9 days; p=0.001). The group that underwent laparoscopy had fewer wound infections and ongoing pain. After a year, the laparoscopic group had a recurrence rate of 2%, whereas the open group had a rate of 6%. Following laparoscopic repair, patient satisfaction and quality-of-life ratings increased. Conclusion: Laparoscopic inguinal hernia repair offers improved postoperative recovery, less discomfort, less hospitalizations, fewer problems, and higher patient satisfaction, making it a safe and effective alternative to open surgery despite a longer operating time.
Background: Congenital pouch colon (CPC) is an unusual congenital abnormality in which a pouch-like dilatation of a shortened colon is associated with an anorectal malformation (ARM), predominantly reported from the Indian subcontinent. Certain rare variants may closely mimic Hirschsprung’s disease (HD) as they are not associated with an ARM and present later in life. The radiological findings too favour HD. This results in diagnostic confusion.Case Report: A 3-year-old boy presented with long-standing constipation and intermittent abdominal distension. Radiological evaluation suggested HD. Exploratory laparotomy revealed a Type II CPC with a proximal colonic pouch and a distal shortened segment of normal-calibre colon terminating in anal stenosis. A diverting ileostomy was performed, with a plan for staged definitive reconstruction.Conclusion: Rare variants of CPC should be considered in the differential diagnosis of children presenting withconstipation and imaging suggestive of HD, as the surgical management and prognosis differ significantly and this is the main teaching from this case.
Background: The clinical signs of peritonitis in patients with strangulated inguinal hernia, causing perforated small intestine diverticulosis, are often difficult to be recognized. The clinical signs of diverticulosis can be similar or even misdiagnosed with abdominal wall hernia because the pathology of both diseases has some similarities in their mechanisms. Multiple studies indicate that connective tissue disorders might significantly contribute to the development of diverticulosis and hernias in the abdominal wall. Case Report: A 64-year-old male presented with sudden-onset abdominal pain lasting six hours. He also reported a palpable, non-reducible mass noted in the left inguinal region, accompanied by nausea and vomiting. On physical examination, there was tenderness, rebound tenderness, and defans muscular tense in the entire abdominal region, and a non-reducible mass was palpable in the left inguinal region. Five mililiter of brown gastric fluid was obtained from the NGT tube. The results of a plain abdominal X-ray were dilatation of the small intestine and large bowel; no step ladder image, no free air was seen, and the psoas line was not visible. The diagnosis of small intestine diverticulosis with perforation was concluded during exploratory laparotomy based on indications of peritonitis. Conclusion: The clinical signs of diverticulosis can resemble an inguinal hernia, so surgeons need to be aware of this occurrence to select the treatment and avoid post-operative worsening.
Vaginal intraepithelial neoplasia (VaIN) and primary vaginal malignancies represent a rare subset of lower genital tract neoplasms, accounting for approximately 1% of all gynecological cancers. VaIN, a precursor lesion with substantial oncogenic potential, remains a diagnostic and therapeutic challenge. Its incidence is increasing due to heightened awareness, expanded cytologic and HPV screening, and routine colposcopic evaluation. Risk factors include prior cervical intraepithelial neoplasia, hysterectomy for CIN, immunosuppression, prior pelvic irradiation, persistent high-risk HPV infection, smoking, HIV, and diethylstilbestrol (DES) exposure. The vaginal microbiome's composition is increasingly recognized as a determinant of host susceptibility to HPV and neoplastic transformation. The Lower Anogenital Squamous Terminology (LAST) classifies VaIN into low-grade (VaIN 1) and high-grade squamous intraepithelial lesions (VaIN 2 and 3), with the latter harboring a significant risk of progression to invasive disease. High-grade VaIN necessitates definitive treatment, whereas low-grade lesions may be monitored. Therapeutic modalities include wide local excision, laser ablation, LEEP, and in select cases, upper vaginectomy. Non-excisional therapies such as CO₂ laser vaporization, photodynamic therapy, and plasma energy ablation are feasible in the absence of invasion. The choice of treatment should be individualized based on lesion extent, visualization, and prior therapies. Recurrence is not uncommon, warranting vigilant long-term surveillance. Primary vaginal carcinomas, chiefly squamous cell in origin, are staged clinically using FIGO and TNM classifications. Definitive management involves external beam radiotherapy (EBRT) with concurrent chemotherapy, followed by image-guided adaptive brachytherapy. Prognosis is primarily stage-dependent. Uncommon histologic subtypes such as vaginal melanoma and sarcomas pose unique diagnostic and therapeutic considerations due to their aggressive nature and rarity. This review consolidates the evolving landscape of VaIN and vaginal cancer, emphasizing diagnostic standardization, risk stratification, and a tailored multimodal treatment paradigm aligned with contemporary oncologic principles.
Struma ovarii (SO) is a rare ovarian tumor, constituting 1% of all ovarian tumors and 3% of ovarian teratomas, predominantly composed of thyroid tissue. While typically benign, SO can undergo malignant transformation. We report a case of a 41-year-old woman with a six-month history of abdominal distention. Imaging revealed a solid cystic mass in the right adnexa with ascites and elevated CA125 levels. The surgical intervention included a hysterectomy and bilateral salpingo-oophorectomy, with pathology confirming struma ovarii with follicular thyroid carcinoma. Postoperative recovery was uneventful, and all follow-up tests were normal. This case underscores the diagnostic challenge posed by SO due to its resemblance to ovarian cancer and highlights the importance of thorough exploration, pathological examination, and long-term follow-up. Serum thyroglobulin levels can be an effective marker for monitoring tumor recurrence. Our findings contribute to the understanding and management of SO with malignant transformation.
