Two days of octreotide infusion following endoscopic therapy is sufficient and as efficacious as 5 days of infusion in preventing early rebleed, with reasonably better cost-effectiveness.

BACKGROUNDAntibiotic prophylaxis use in mesh inguinal hernioplasty is controversial. A recent Cochrane review based on 17 randomised trials did not reach a conclusion on this important topic. Hence this study is designed to define the role of prophylactic antibiotics in mesh repair of inguinal hernia.

Incisional hernia is a common complication following an abdominal surgery. They have ideally managed with open/ laparoscopic mesh repair. Mesh related complication are many due to increasing number of surgeries. This is a case of complete transluminal migration of a IPOM mesh and an eroding Onlay mesh presenting as a sub-acute intestinal obstruction after 2 years of incisional hernia surgery. Mesh migration is one of the complications of incisional hernia repair because of inadequate fixation or by ongoing inflammation (foreign body reaction). Complete trans luminal mesh migration is a rare complication with very few reports noted on bowel and urinary bladder. Transluminal migration into small bowel is a rare complication and it should be considered in differentials whenever patient comes with abdominal symptoms with past history of hernia repair.

Hemangiolymphangioma (HL) is a rare benign tumor, commonly present in pediatric age group that involves the head and neck. Small bowel HL has been reported as solitary or segmental involvement. Here we report a case of diffuse small bowel HL, presented as chronic anemia, fatigability and obscure gastrointestinal (GI) bleeding. A 42-year male presented with 15 years history of bleeding per rectum, anemia, and fatigability, received multiple blood transfusions. The exact cause could not be identified. His complete hemogram parameters were low requiring further imaging studies. Imaging and intraoperative enteroscopy showed multiple nodular lesions in mesentry as well as in the mucosa of the entire small bowel. Bleeding points were noted in a proximal jejunal lesion which was resected. Histopathological study confirmed as benign HL. HL are rare tumors of gastrointestinal tract. To the best of our knowledge diffuse HL of the small bowel have not been reported in the medical literature. With this case scenario, one should consider these tumors in the differential diagnosis of obscure lower GI bleed and chronic anemia, as well as explore definitive management options for these benign symptomatic tumors.