Ahmed Nabil

long/short is a better word. The Higher the defect ,The shorter the COMMON WALL & The LOWER the defect the longer the Common wall

case of prof Tariq Altokais from KKUH, Riyadh, Saudi Arabia. a case of female patient 8m old with black tarry stool since the age of 4m, and on/off milk reflux/vomiting. +ve occult blood in stool, patient is failing to thrive (current weight 6.1kg), -ve Meckel scan and was prepared for upper GI endoscopy by pediatric GI team. presented suddenly two days ago with persistent dark bilious vomiting of large amount. abdominal u/s done and was negative, upper GI contrast study revealed arrest of dye at DJ junction at the time of study, with passage of contrast in the after 1 hrs delayed film. diagnostic laparoscopy done for the patient and a proximal jejunal intussception found just distal to DJ junction, which reduced laparoscopcally, and we found a suspicious thickened dilated segment of proximal jejunum, then umclical incision extended and this jejunal segment delivered outside the abdomen and opened to find a intraluminal polyp, resection anastomosis done. Pathology result: hamartomatus polyp

Thank you for your questions 1- this discovered intraoperatively 2- no risk factors identified 3- presentation is left inguinal hernia 4- there was associated big left hernia sac 5- no bleeding source identified (bleeding was inside abdominal hydrocele, no history of trauma!?!)

A case of left abdomenoscrotal hematocele in a three yrs old patient, originally operated for left UDT with left inguinal hernia. operated through groin incision A abdominal part of hematocele delivered to groin B inguinal hernial sac C cord including vas and vessel D Lt testis