•First kind of case report in literature.•A unique case with double direct and triple indirect type of inguinal hernia.•Named as Jammu Kashmir and Ladakh Hernia.•Inferior epigastric artery may ...traverse an anomalous course in inguinal canal.•Presence of multiple hernia sacs ,if undetected, is risk for recurrence.
Double direct and triple indirect type hernia in unilateral inguinal hernia is unique. Anomaly of pathway traversed by inferior epigastric artery is always of surgical importance. Meticulous exploration of the groin is mandatory for diagnosis of rare hernia.
A 46 year old male presented with the right groin swelling. An inguinal hernia having two direct types separated by anamalous inferior epigastric artery and three indirect types of hernia were present. There was one bubonocele and two funicular types of indirect type of hernia present on the single cord. Anamalous inferior epigastric artery lying superficially at midpoint of inguinal canal was buttresed in the posterior wall to prevent its entrapping in mesh. Individual ligation of the indirect sacs and Lichtenstein repair was done.
This is first kind of unique case report with the new type of hernia reported in the English literature after searching Pubmed, Medline, Google Scholar and Embase database. This new hernia, Double Pantaloon hernia, as a mark of respect and unity, is named after its State of origin, “Jammu, Kashmir and Ladakh” so called as “Jammu Kashmir and Ladakh Hernia”.
Double direct and triple indirect type hernia in a unilateral inguinal hernia is unique. Presence of multiple hernia sacs in the inguinal hernia is a risk for recurrence, if not detected. Inferior epigastric artery in inguinal canal may traverse an aberrant course.
De novo reference intervals (RIs) for a total of thirty two hematological and serum biochemical attributes were established for rainbow trout (Oncorhynchus mykiss) cultured in Himalayan aquaculture ...system. For this purpose, long term assessment of hemato-biochemical parameters was carried over a period of one year from March 2019 to February 2020 and a total of 444 blood samples were analysed. Blood examination results were recorded systematically and reference intervals were established, notably for erythrocyte parameters: hematocrit (Hct) 29–40%, hemoglobin 8.32–12.28 g/dL, red blood cell (RBC) count 1.01–2.04 (×106/mm3); leukocyte parameters (x 103/mm3): total leukocytes 31.32–90.60, neutrophils 4.21–18.85, total lymphocytes 20.55–63.63, small lymphocytes 14.86–46.50, large lymphocytes 6.35–22.34 and monocytes 1.22–7.56; thrombocyte count 23.00–68.00 (×106/mm3). RIs were also established for red blood cell indices, vital serum constituents involved in carbohydrate, protein, lipid and nitrogen metabolism including the less known, diagnostically important, serum enzymes and electrolyte concentrations. Principal component analysis revealed that certain serum components were more efficient at distinguishing between the life stages (juvenile, adult) of fish by explaining about 92.7% of variation in the whole dataset compared to the principal hematological components which explained only about 80% of the variation. Significant (P < 0.05) differences were noted for RBC count, total leukocyte count (TLC), total protein, total cholesterol and uric acid with respect to the sex of fish. Moreover, clearly differentiable morphometric and morphological attributes were also noticed among erythrocytes, leukocytes (lymphocytes, neutrophils and monocytes) and thrombocytes. To our knowledge, the present study is the first of its kind that elucidates blood chemistry of cultured rainbow trout, O. mykiss in accordance to the guidelines framed by the American society of veterinary clinical pathologists (ASVCP). RIs reported here can help monitor the fish health status by improving the use of non-lethal diagnostics in piscine medicine.
Giant epididymal or spermatic cyst, testis and cord as content of sac in an indirect hernia is very rare.
A 61 year old male with scrotal swelling was diagnosed as a case of giant epididymal cyst. ...Exploration documented giant epididymal cyst and an indirect inguinal hernia of complete type with the cord, testicle and epididymal cyst as a content of sac. Excision of epididymal cyst with placement of cord outside sac was done. This is the first kind of unique case report with new type of indirect hernia reported with cord as the content of sac named as “Srinagar Hernia”.
Giant epididymal cyst is rare. Cord inside sac of indirect hernia is to be made extrasacal to prevent recurrence.
•Extremely rare.•First Kind of case series in Literature.•Giant Spermatocele extremely Rare.•Cord and testis inside hernia sac never reported.
Introduction: Giant spermatocele,testis and spermatic ...cord as content of sac in an indirect hernia is extremely rare. These are congenital in.nature.
Case Report: A 61 year old male was diagnosed as a case of giant spermatocele.Exploration documented giant spermatocele and an indirect inguinal hernia of complete type with the testicle, cord and spermatocele as a content of herrnia sac Excision of spermatocele with placement of cord outside sac was done.This is a first kind of case report with new type of hernia reported with cord as content.
Conclusion: Giant spermatocele is to be excised.Testis and spermatic cord inside hernia sac have to be made extrasacal to prevent recurrence.
PDF
