Desmoid tumors, while generally benign histologically, can exhibit locally aggressive behavior, especially when located in the anterior abdominal wall. This case report explores the management of a rare giant desmoid tumor complicated by concurrent lymphedema, emphasizing the nuances of diagnosis, treatment decisions, and their impact on the patient\'s quality of life. The patient, a 55-year-old obese individual with a BMI of 47, presented with a 25 cm mass in the right paraumbilical region, alongside significant lymphedema in the right lower limb and associated inguinal lymphadenopathy. Abdominal CT revealed a well-defined soft tissue mass in the right paramedian hypogastric region, suggestive of a desmoid tumor. Surgical intervention involved a monobloc resection of the mass with a 5 cm lateral margin, including the right rectus abdominis muscle and associated aponeuroses, and subsequent reconstruction using a biface intraperitoneal synthetic mesh. Postoperative recovery was marked by the resolution of lymphedema and a return to full function of the affected limb. Histopathological examination confirmed the diagnosis of a desmoid tumor. This case underscores the importance of radical surgical resection with adequate margins and appropriate reconstruction to achieve favorable long-term outcomes. The report provides insights for future research and therapeutic advancements in the management of desmoid tumors.

Abdominal wall hernias are one of the most common surgical diseases present in both males and females nowadays. However, with only a few cases reported in the literature, hepatic round ligament hernias are a rare clinical manifestation. This case shows how a common symptom such as epigastric pain can be associated with this rare condition. In general, abdominal computed tomography (CT) images are the choice of study to evaluate complications and the involvement of different intestinal sections. Some laboratory tests can be performed to suspect intestinal ischemia secondary to strangulated hernias. Primary repair utilizing mesh is the preferred surgical treatment. This procedure can be performed through laparoscopic or open technique, depending on the surgeon\'s skills and patient preference.

Spigelian hernia is a rare type of abdominal wall hernia that accounts for only 0.12% of all abdominal hernias. A Spigelian hernia, also known as a spontaneous lateral ventral hernia or a hernia of the semilunar line, occurs when a part of the abdominal contents protrudes through the Spigelian fascia. Due to its anatomical location, Spigelian hernia can be difficult to diagnose through physical examination alone. Here we report a case of a 40-year-old female who experienced right abdominal pain and swelling, where ultrasonography imaging was crucial in the intraoperative diagnosis of Spigelian hernia. The patient underwent laparotomy mesh repair to address the condition. The lack of consistent physical findings and the rarity of the disease require a high level of clinical suspicion in the diagnosis of a Spigelian hernia. Its associated abdominal complaints are often vague and nonspecific, making it even more challenging. This case emphasizes the importance of utilizing imaging techniques to aid in the diagnosis of a Spigelian hernia and prompt surgical intervention to prevent complications associated with the hernia.

UNASSIGNED: In resource limited settings, epidural anesthesia can be a safe option for elderly patients with aortic stenosis for lower abdominal surgeries as the hemodynamic changes are known to be less as compared to spinal or general anesthesia.
UNASSIGNED: Spinal or general anesthesia in an elderly patient with aortic stenosis is always a challenge for anesthesiologists. It is even more challenging in a resource limited setting. The marked hemodynamic changes associated with either spinal or general anesthesia increase the morbidity and mortality. We present a case of right inguinal hernia in a 71-year-old patient with hypertension, bradycardia, and moderate aortic stenosis planned for open mesh repair under sole epidural anesthesia.

BACKGROUND: Abdominal hernias, including incisional hernias, can occur due to weakness in the abdominal wall. Incisional hernias commonly occur following surgical incisions, and factors such as poor closure technique and patient-related factors can contribute to their development.
METHODS: In this case, the patient was presented with a painful, irreducible lump over a previous laparotomy scar, along with bowel obstruction symptoms. The diagnosis was supported by ultrasound findings showing obstructed bowel loop in the hernial sac. Emergency open surgical reduction and mesh repair were performed to treat the strangulated hernia and ensure the mother and fetus\'s safety. The patient had an uneventful postoperative period and was discharged after three days.
CONCLUSIONS: Incisional hernias can be diagnosed through clinical evaluation, and imaging studies may be necessary in complex cases. However, imaging techniques such as X-rays and Computed Tomography scans are limited in pregnant women due to the radiation risks. Ultrasonography (USS) is preferred in pregnant women for its safety and non-invasiveness, although it may have reduced sensitivity in obese patients. Complicated hernias should be treated with emergency surgical repair, while elective surgery can be considered for asymptomatic or non-complicated hernias. Laparoscopic surgery offers advantages such as shorter hospital stays and fewer complications. Mesh repair reduces the recurrence risk in subsequent pregnancies (relate the discussion with the case).
CONCLUSIONS: Overall, surgical management of hernias in pregnancy requires careful consideration of individual circumstances and the use of appropriate techniques to ensure the safety of both the mother and fetus.

UNASSIGNED: Diaphragmatic hernia does not only occur during high velocity impact or penetrating injury, but also can occur when heavy loads impact the torso. Diaphragmatic hernia must be ruled out in a patient with polytrauma with a chest X-ray at the least.
UNASSIGNED: Trauma-induced diaphragmatic hernia is a protrusion of abdominal contents through the defect in diaphragm and is an uncommon and less heard of injury. This case report conveys that diaphragmatic hernia should be ruled out in any polytrauma case presenting with shortness of breath with the chest X-ray at the least.

UNASSIGNED: Transdiaphragmatic intrapericardial herniation (DIPH) of intra-abdominal organs is a rare but potentially life-threatening phenomenon often requiring urgent repair. There are currently no guidelines on the preferred repair technique in this situation.
UNASSIGNED: Retrospective case report with long-term follow-up. We describe a case in which the left liver herniated into the pericardium after coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA).
UNASSIGNED: Urgent laparoscopic reduction of the liver herniation and repair of the large diaphragmatic defect was performed using an expanded polytetrafluoroethylene (ePTFE) mesh in a 50 year old male patient. Hemodynamic instability normalized after the hernia reduction. The postoperative course was uneventful. CT-scan evaluation after 9 and 20 years of follow-up showed perfect integrity of the mesh.
UNASSIGNED: A laparoscopic approach for DIPH is feasible in emergency situations provided sufficient hemodynamic stability of the patient. On-lay ePTFE mesh repair is a valid option for such repairs. We illustrate the long-term durability and safety of ePTFE for DIPH repair in what seems to be by far the longest documented follow-up after laparoscopic ePTFE mesh repair for DIPH.

BACKGROUND: The finding of a vermiform appendix within the peritoneal sac of an inguinal hernia is called Amyand\'s hernia. The reported incidence of Amyand\'s hernia and femoral hernia is 1% and 3.8%, respectively. To our knowledge, no cases have been reported in the literature that associate these two entities. We present the first case of incarcerated left-sided Amyand\'s hernia and synchronous ipsilateral femoral hernia found during emergency surgery.
METHODS: A 72-year-old woman was admitted to the Emergency Department for a complicated left inguinal hernia. An inguinotomy was performed that detected a large direct hernial sac and a synchronous femoral hernia. The opening of the inguinal hernia showed the presence of the cecum and the appendix, both without signs of inflammation. The femoral space was evaluated transinguinally, identifying the larger omentum that had slipped into the femoral canal. The primary closure of the posterior wall defect was performed with the McVay technique due to its large size, and then the hernioplasty was completed with a polypropylene mesh. No postoperative complications were reported.
CONCLUSIONS: In the context of an incarcerated Amyand\'s hernia, the decision to perform an appendectomy in addition to hernia repair with or without mesh will depend on intraoperative findings.

A pantaloon hernia occurs when an indirect and direct hernia develop at the same time. The urinary bladder is a rare component of pantaloon hernias. There is a lack of literature regarding an ipsilateral pantaloon with a herniated urinary bladder. Clinically, it has a vague presentation associated with abdominal pain and urinary retention symptoms. The best diagnostic modality is an abdominal CT scan. Surgery is the treatment of choice, rendering a good prognosis. Untreated bladder hernia may lead to strangulation and necrosis of the urinary bladder. We present a rare case of a right-sided pantaloon hernia with a bladder herniation in a 65-year-old man.

A severe deformity that can occasionally be detected in infants and younger children is a congenital diaphragmatic hernia (CDH). Congenital diaphragmatic hernia is characterized by the existence of a diaphragmatic defect, most frequently to the left and posterolateral, known as Bochdalek hernia, that allows abdominal contents to herniate into the thorax. The diagnosis of this rare congenital diaphragmatic hernia is made in early childhood. When the right-sided congenital diaphragmatic hernia, which is uncommon, is asymptomatic in adulthood, the diagnosis can be challenging. We present a rare case of this condition presenting in adult life which was identified as an incidental finding when the patient was receiving treatment for dextrocardia with right bundle branch block during his teenage. To avoid entrapment and strangulation of abdominal viscera, surgical repair is advised for all adult CDH patients. Currently, numerous studies have shown that open or minimally invasive repair procedures, with or without mesh reinforcement, can be used safely and effectively. Surgical repair has been linked to minimizing morbidity and mortality, excellent long-term results, and a low rate of recurrence regardless of the method used. Reinforcement by using suture repair with mesh was preferred in this case. This case report highlights the uncommon adult right-sided Bochdalek hernia presentation and the requirement for intense clinical attention in cases that are comparable to it.