In a retrospective study of 133 cases of inguinal hernia in infants and children upto the age of14 years, treated surgically at Western Regional Hospital, Pokhara, Nepalbetween April 1st 1997 and March 31st 1999, it was found that male patients out numberfemale patients in the ratio of 13.7:1 Right sided hernia was almost twice as common ascompared to left. Only 1.5% of patients (2cases) had bilateral inguinal hernia. 4patients (3%) presented with obstructive features. Routine exploration of contralateralside was not done as most surgeons do not recommend this, as only 20% develop herniaon the contralateral side.1 Only one patient had recurrent hernia.Key words: Congenital, hernia, inguinal, retrospective, incarceration.
Isolated duodenal injury is rare as they are usually associated with other visceral injuries. Diagnosis of a duodenal injury is difficult, and its management is challenging. Hence, it is important to timely recognize such injuries for better outcome.
Male breast carcinoma is a rare malignancy (<1% of all breast carcinomas, 0.2% of all male malignancies). Its common histopathological type is infiltrating carcinoma, not otherwise specified. Three male patients aged 56 (stage –IIIB), 64 (T4bN0M0) and 78 (T2N0MO) years presented with a breast lump within a year. Their hematological and biochemical parameters were within normal limits. Two of them had palpable regional lymph nodes. Male breast carcinoma occurs in older males as in our cases. Two cases showed infiltrating ductal carcinoma, not otherwise specified on histopathological evaluation, and one showed special type with apocrine differentiation. Their two-year follow-up was uneventful after modified radical mastectomy and chemotherapy. Male breast carcinoma is associated with risk factors different from and overlapping with female breast carcinoma. Male breast carcinoma differs from female breast carcinoma on clinical presentation, biological behaviour and prognosis.
Paraduodenal hernia, a rare internal hernia, is an uncommon cause of small bowel obstruction. We present a case report of a 45-year-old male presenting to the emergency department with complaints suggestive of small bowel obstruction. Abdominal plain X-ray was also suggestive of small bowel obstruction. Emergency laparotomy showed intraoperative findings of right sided paraduodenal hernia with dilated small bowel. Postoperative hospital stay was uneventful and the patient was doing well during 24 months of follow up with no active complaints. Paraduodenal hernia should be considered as part of the differential diagnosis of small bowel obstruction in patients who have repeated attacks and no prior history of abdominal surgery. Surgeons need to have an astute clinical acumen in diagnosing internal hernias to avoid repercussions and fatal events.
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