Chylous ascites refers to the leakage of lipid rich milky fluid into the peritoneal cavity. This usually occurs following trauma or obstruction of the lymphatic system. Moreover, an existing clear ascitic fluid can turn chylous as a secondary event. Milky appearance on gross appearance along with high fat (triglyceride) content usually suggestive of the diagnosis. We are reporting a 3 months infant with chylous ascites diagnosed during bilateral INGUINAL herniotomy. The patient presented bilateral scrotal with umbilical swelling for last one month. Examination showed bilateral INGUINAL HERNIA, umbilical HERNIA with mild abdominal distension. Bilateral herniotomy and subsequent ultrasound guided paracentesis revealed milky peritoneal fluid. Biochemical analysis revealed plenty of lymphocytes, high triglyceride content with increased cellularity and no abnormal cells suggestive of chylous ascites. Lymphoscintigraphy revealed leak from retroperitoneal lymphatics. Child improved following dietary modification and octreotide therapy without any surgical intervention. The aim of this case report is to describe the unusual presentation, it’, s clinical and biochemical factors and role of conservative treatment of a patient with congenital chylous ascites.

Introduction: INGUINAL HERNIAs are common diseases in the population, and the prevalence of colorectal cancer has increased significantly in recent decades. However, the concomitant association of these two entities is rarely described in the literature. In most cases, due to the complex diagnosis, patients are treated in emergencies with obstruction or perforation. Nowadays, there is no established consensus on the best surgical approach when this association exists. Case Presentation: We report a case of an 84-year-old patient admitted to the emergency room with a chronic inguinoscrotal HERNIA, with signs of intestinal obstruction, being diagnosed in the preoperative period by computed tomography, a neoplasm of the sigmoid colon incarcerated in the HERNIAl sac. The patient underwent radical oncologic surgical treatment and INGUINAL herniorrhaphy through two access routes, with good postoperative evolution and outpatient follow-up after sixteen months. Conclusions: The association between CRC and INGUINAL HERNIA is unusual, but the surgeons should keep this possibility in mind because the treatment must be aimed to accomplish a safe oncologic outcome and as optimal as possible HERNIA repair.

The INGUINAL HERNIA affects 3-8% of the general population; and 80-83% of all HERNIAs are located in the INGUINAL area. 1 Approximetely, 75-85% of the patients are men. The HERNIAtion of the bladder into the INGUINAL canal is very rare and the incidence is 1-3% among men over the age of fifty. INGUINAL bladder HERNIAtion was first described by Lavine in 1951. 2 There are three forms of bladder HERNIAtion including para-peritoneal, intraperitoneal, and extraperitoneal. 3 Most of the patients are asymptomatic and diagnosed incidentally. The clinical presentations of the patients are dysuria, hematuria, urinary obstruction symptoms, and INGUINAL swelling. Imaging modalities are intravenous urography, cystography, ultrasonography, computed tomography, and magnetic resonance. Cystography is the gold standard method for the diagnosis....

Since 1884, when Bassini performed the first true herniorrhaphy,I different types of repairs have been used for treating INGUINAL HERNIAs.I-7,13,IS,17,IS The aim of all was reduction of postoperative complications, but the recurrence rate remained about 10%.8-12,14,16,1In7,1987, Abrahamson reported his nylon darn repair and claimed that the recurrence rate was 0.8% with this method. With the aim of decreasing the recurrence rate, operation cost and postoperative complications, the author has modified the darn method .and used it for the repair of 1480 INGUINAL HERNIAs in 1452 patients. The results have been excellent; the recurrence rate was 0.22%, and postoperative infection was 1%. It is a cost-effective and simple method.

Background & Aims: HERNIA disease occurs when an area of an organ or tissue protrudes through a weak muscle layer. The most common treatment of this disease is HERNIA surgery, which is performed with anesthesia in two ways, open and closed. Anesthesia in older people with underlying diseases will be risky. In this case study, due to the high age of the patient candidate for HERNIA surgery, the patient was anesthetized through hypnosis. Case Report: The case was an 87-year-old woman who was admitted to a hospital in Sari with the diagnosis of INGUINAL HERNIA and was discharged from the hospital one day after surgery with the help of hypnotic anesthesia. Hypnosis was performed by a psychiatrist and a psychotherapy fellowship who had completed a hypnotherapy course at the Iranian Clinical Hypnosis Association. Conclusion: Since there is no medical treatment for HERNIA and its definitive treatment is surgery, the complications caused by anesthesia medications are high in the elderly. So, using hypnotic anesthesia is a suitable way to reduce the complications caused by anesthesia. Using hypnotic anesthesia is recommended for other high-risk patients who are candidate for surgery.