Highlights Study deals with rare case of ileal atresia with double appendix & associated congenital anomalies. Chromosomal & genetic typing of the infant is necessary as he had other associated anomalies. Study dealt with resection & anastomosis of the bowel & the surgical outcome depends on the presentation of the baby & the time taken to initiate surgical intervention. Post op care & regular follow up determined the success of the surgical intervention.

Background: The ideal operation to treat inguinal hernia is still far to define. The Shouldice method and other tissue-based techniques are still acknowledged to be acceptable for primary inguinal hernia repair according to European Hernia Society guidelines. Desarda’s technique, presented in 2001, is an original hernia repair method using an undetached strip of external oblique aponeurosis. This randomized trial compared outcomes after hernia repair with Desarda and mesh-based Lichtenstein techniques.Methods: A total of 42 participants (40 males and 2 females) were randomly assigned to the Desarda (group 1) and Lichtenstein (group 2), 19 vs 23 respectively. The primary outcomes measured were recurrence (for maximum follow up of 1 year and minimum of 5 months) and chronic pain. Additionally, operative time, early and late complications, foreign body sensation, and return to everyday activity were examined in hospital and at 7, 30 days, and 6, 12 months after surgery.Results: During the follow-up, one recurrence was observed in Desarda group after 10 months of surgery. Chronic pain was experienced by 10.5% and 8.7% of patients from groups Desarda and Lichtenstein respectively. Foreign body sensation and return to activity were comparable between the two groups. Operative time was less in Desarda group. There was significantly less seroma production in the Desarda group.Conclusions: The results of primary inguinal hernia repair with the Desarda and Lichtenstein techniques are comparable at the 1 year follow up. The technique may potentially increase the number of tissue-based methods available for treating groin hernias.

A 3 years old boy attended emergency department with history of abdominal distension, fever, vomiting, loose stools for 5 days. The boy was suffering from epilepsy from last 1 year of age and was under treatment. From history and clinical examination, it seemed to be a case of peritonitis. Abdominal ultrasound revealed debrigenous free fluid in peritoneal cavity. Emergency exploratory laparotomy done and pyloric perforation was noted and repaired by modified graham’s patch. The child, post-operatively, suffered from dys-electrolytemia and wound site infection and recovered with treatment.

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