Trichobezoar is a very rare condition that is usually diagnosed at a late stage due to etiology of the condition. It is usually seen in young females who invariably have a psychiatric disorder like trichotillomania, trichophagia or depression. Here we report a case of trichobezoar which presented in the surgical out-patient department of our hospital.
Background: Inguinal neuralgia is one of the important complications of hernia repair which occurs due to entrapment, neuroma or fibrotic reactions involving the ilioinguinal nerve. Hence the excision of ilioinguinal nerve should theoretically eliminate the possibility of inguinal neuralgia. But routine ilioinguinal neurectomy is still controversial and is not widely accepted. Hence a study was conducted to evaluate the effect of prophylactic ilioinguinal neurectomy in open inguinal hernia repair.Methods: A prospective study was conducted in the General Surgery Department in a tertiary center for a period of 20 months, from December 2011 to July 2013. The patients were randomly allocated to either group A or group B by block randomized technique. Group ‘A’ patients underwent neurectomy of ilioinguinal nerve whereas the ilioinguinal nerve in group ‘B’ patients was safeguarded.Results: A total of 60 patients were studied with 30 patients each in group A and group B. During vigorous activities, more group B patients had pain compared to group A patients at 4-month [15 (50%) vs. five (17%); p=0.006; Chi-square test] and 8-month follow-up [15 (50%) vs. five (17%); p=0.006; Chi-square test].Conclusions: Inguinal neuralgia is a significant and debilitating complication following hernia repair. The prophylactic neurectomy can be an appropriate solution in the prevention of chronic groin pain following inguinal hernia repair and can be considered as an ideal inclusion into the standard hernia repair procedures.
Background Forgotten or retained (double-J) DJ stents may lead to several complications. Management of retained DJ stents poses a challenge for urologists not just surgically but also medicolegally and adds to the economic burden of the patient. Difficulty in follow-up for patients due to the contagious nature of COVID-19 and several restrictions posed in the form of lockdown. Smartphones today have become an integral part of our daily lives providing a convenient and reliable platform for data storage and access. Methods All patients requiring placement of DJ stents and agreeing to enrol in the study were registered on the application over the physicians smartphone. SMSs regarding dates for removal of stent and follow-up with the literature regarding stent care were sent to the patients in their regional language. Results A total of 100 patients were stented during this period of 3 months. Mean age was 42.61 years with three patients of paediatric age group. Mean duration of stent was 6 weeks. All patients received periodic messages (average 3) regarding follow-up and date for stent removal. 3%(n = 3) patients were delayed for follow-up; 2% (n = 2) patients lost to follow-up, compared to a 9% to 10% loss to follow-up in patients followed up only on paper discharges in our department previously. Conclusion It significantly reduced the number of physical visits of the patient to the hospital and provided a more streamlined tracking of the indwelling stents for the user; patient compliance was found to be almost 98%; being cloud based (android/iOS), it was easily accessible to the user; and with the option of sharing the account details, the patient record could be accessed by several residents from their individual devices, which significantly reduced loss to follow-up rates from 9 to 2%.
Meckels diverticulum is a persistent remnant of the omphalomesenteric duct. It presents the most common congenital anomaly of the small intestine (1-4%). Common complications related to a Meckel's diverticulum include hemorrhage, intestinal obstruction, and inflammation. Small bowel obstruction due to mesodiverticular band of Meckel's diverticulum is a rare complication. Herein, we report the diagnosis and management of a small bowel obstruction occurring due to mesodiverticular band of a Meckel's diverticulum.
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