RESUMEN
BACKGROUND: Giant inguinoscrotal hernias are huge inguinal hernias that extend below the midpoint of the inner thigh in the standing posture. Giant inguinoscrotal hernias are rare in developed countries because of their better medical resources and early treatment. However, they can develop in patients who refuse surgery or ignore their condition. Intervention is inevitable because strangulation and organ perforation can occur, leading to peritonitis and sepsis. Common surgical approaches include open abdominal and inguinal approaches or a combination of both. CASE SUMMARY: We present the case of a 73-year-old man who visited our emergency department with a huge mass in his left scrotum and septic complications. Abdominal computed tomography revealed a large left inguinoscrotal hernia that contained small bowel loops and the colon. Emergency surgical intervention was performed immediately because intestinal strangulation was highly suspected. The operative repair was performed using a combination of mini-exploratory laparotomy and the inguinal approach. The incarcerated organs, which included the ileum and sigmoid colon, had relatively good intestinal perfusion without perforation or ischemic changes. They were successfully reduced into the abdomen, and bowel resection was not necessary. A tension-free prosthetic mesh was used for the hernia repair. Two weeks after the initial surgery, and with adequate antimicrobial therapy, the patient recovered and was discharged from our hospital. No evidence of hernia relapse was noted during the outpatient follow-up examination 3 mo after surgery. CONCLUSION: Emergency surgery involving combined mini-exploratory laparotomy and the inguinal approach should be performed for serious incarcerated giant inguinoscrotal hernias.
RESUMEN
This study investigated the effect of supplementation with chicken extract on plasma and colostrum protein compositions in lactating women. Thirty healthy pregnant women were evenly divided into the control (n = 15) or chicken extract (CE) group (n = 15). The CE group was given one bottle (70 mL/bottle) of chicken extract three times a day to provide 18 g protein from the 37th week pregnancy to 3 days postpartum. All women in the CE group consumed chicken extract at least for 2 weeks (18 +/- 5 days). High protein supplement was restricted in the control group. Blood samples were collected during the 37th week pregnancy and 3-day postpartum, and milk was collected during 3-day postpartum. The results showed that plasma total protein was significantly lower by 14% in the CE group compared with that in the control group during 3-day postpartum. Plasma epidermal growth factor (EGF) significantly elevated by 236% during 3-day postpartum compared with those during the 37th week pregnancy in the CE group. The levels of lactoferrin, EGF, and transforming growth factor-beta2 (TGF-beta2) in colostrum significantly increased by 34%, 62%, and 196%, respectively, in the CE group compared with those in the control group. However, the levels of total protein, casein, lactalbumin, and secretory immunoglobulin A in colostrum did not significantly differ between two groups. Therefore, supplementation with chicken extract increased colostrum levels of lactoferrin, EGF, and TGF-beta2, which are important for the growth and immune functions of the infants, in lactating women.
