Repair of inguinal hernia is one of the most commonly performed pediatric surgical procedures. The standard of treatment has been open herniotomy (OH). Recent trends have shown promising results with use of laparoscopy (LH) for the same. The aim of this study was to compare laparoscopic herniotomy with the standard of care at the time of the study, which has become an increasingly common procedure at our center. This was a prospective follow-up study conducted at the Department of Surgery at Nepal Medical College and Teaching Hospital. A total of sixty-four patients who underwent herniotomy were included in the study and followed up for a total duration of two years post-operatively. Immediate post-op pain was assessed with the use of visual analogue scales. Complications, recurrence, and metachronous herniation were noted in the follow up visits. Use of laparoscopy resulted in a longer operative time (36.68 min vs 22.5 min for OH, P <0.001). Pain scores were similar at immediate post-op period (LH 4.18 vs OH 3.93) but decreased significantly for LH compared to OH at 6 hours (3.68 vs 4.31, P = 0.018), 12 hours (2.71 vs 3.62, P <0.001), and 24 hours (2 vs 3.03, P <0.001). Difference in the mean hospital stay was statistically significant (LH 2.02 days vs OH 2.34 days, P <0.001). No recurrences occurred during the follow up period of the study. No patients developed contralateral metachronous hernia during the follow-up period. The cost of OH compared to LH was significantly less. LH is a safer and better alternative to OH for management of pediatric inguinal hernia when comparing post-op pain and hospital stay. However, duration of surgery and cost for the procedure favor OH at present in our setup.

The rectal foreign body is a rare presentation, often related to sexual gratification, sexual assault, or the result of ingestion and rarely accidental, and with rising incidence. We present a case of a 47-year-old heterosexual male with an alleged history of accidental insertion of a foreign body through the anus three days prior without peritonitis or obstipation. After investigations, the patient underwent a failed sigmoidoscopic removal followed by exploratory laparotomy, foreign body removal, and an uneventful post-operative period. It should be noted that early diagnosis and timely intervention are important to prevent complications in rectal foreign bodies. Assessment of the shape, size, nature, and location of the object through appropriate imaging is necessary. Exploratory laparotomy is inevitable in cases of failed manual extraction techniques and complicated cases.

Foreign body ingestions are fairly common and present with obvious symptoms. Certain foreign bodies, like button batteries and magnets, are rarely ingested, but carry with them the extremely dangerous risk of bowel wall necrosis, intestinal perforation and fistula formation. Suspected cases of such ingestions require a high index of suspicion and any delay should be avoided once a diagnosis is made. Herein, we report a case of a 7-year-male patient who presented with abdominal pain and vomiting following similar foreign body ingestion, which resulted in multiple small bowel perforations. The foreign body was removed by a laparotomy, and the affected bowel segments were resected and anastomosed. The patient made an uneventful recovery and was discharged after 5 days.

Right lower quadrant mass in the abdomen has many causes, but gastric perforation is rare. We discuss a 65‐year‐old lady who presented with a history of pain in her abdomen followed by swelling in her right lower abdomen. During the evaluation, a diagnosis of gastric perforation was made.

Desmoid tumors most commonly occur in the anterior abdominal wall in approximately 50% of cases and are locally aggressive. We describe a case of a 38-year-old lady who was investigated as a case of gastrointestinal tumor. Post-operative immunohistochemistry staining showed the presence of a synchronous desmoid in the abdominal wall and proximal ileum. Wide local excision remains the gold-standard of treatment with pharmacotherapeutics and radiotherapy serving as adjuvant or palliative treatment options.