RESUMEN
Giant lumbar hernia, with loss of domain, is a complex scenario to treat. Abdominal compartment syndrome is a dreaded post-operative complication. This can gravely impair the patient's respiratory function and also cause insufficient perfusion of the viscera. Pre-operative progressive pneumoperitoneum can facilitate bowel repositioning and can reduce impairment of the post-surgery lung function, essential for a favourable post-operative outcome. Here, we describe the treatment of a case of giant lumbar incisional hernia by the creation of progressive pneumoperitoneum and hybrid repair of incisional hernia with left posterior component separation and placement of giant prosthetic reinforcement of the defect.
RESUMEN
Non-Hodgkin's lymphoma (NHL) is the most common type of Gastrointestinal (GI) lymphoma with known complications such as bleeding, obstruction and perforation. In this article we present a 59-year-old male patient diagnosed with Peripheral T cell Lymphoma - Not Otherwise Specified (PTCL-NOS) with GI involvement was started on chemotherapy. On day 2 post completion of first cycle of chemotherapy, patient had presented to the emergency department with sudden onset abdominal pain and distension. On evaluation, he was diagnosed with multiple perforations in the small bowel. Patient underwent exploration with primary repair of few perforations and ileal resection with double barrel ileostomy. Chemotherapy plays an important role in the management of NHL. One well-known NHL consequence, intestinal perforation, can happen at the time of initial presentation or after starting chemotherapy. Surgeons should be aware of possibility of such complications and high-risk factors for perforation. At present, there is no role for elective surgery in GI lymphoma and is mainly reserved for complications like uncontrolled bleeding, obstruction or perforation.