Introduction of pediatric laparoscopic inguinal hernia repair in Guatemala.

PURPOSE: Introducing new surgical techniques in a developing country can be challenging. Inguinal hernias in children are a common surgical problem, and open repair is the standard surgical approach. Laparoscopic repair has gained popularity in developed countries because of similar results. This study aimed to determine the outcomes following the introduction of laparoscopic repairs in Guatemala. METHODS: This retrospective analysis of prospectively collected data from all patients under 18 years who underwent laparoscopic repair at Corpus Christi Hospital in Patzun, Guatemala, from September 5th to September 8th, 2022. RESULTS: A total of 14 patients were included in the study. A board-certified pediatric surgeon and a Guatemalan physician performed all cases. The mean patient age was 7.6 years; 7 boys and 7 girls. All patients were interviewed at 7 days, 30 days, and 6 months. There were no postoperative infections, pain requiring re-evaluation, gonadal atrophy, or hernia recurrence. CONCLUSION: Under controlled circumstances with limited but proper equipment and disposables, laparoscopic inguinal hernia repairs can be introduced and performed in a developing country with a risk complication profile comparable to that in developed countries. This study provides promising evidence of laparoscopic repair feasibility and safety where surgical resources are limited.

Challenges in diagnosis and treatment: a case report on a mixed malignant Müllerian tumor.

Mixed malignant Müllerian tumors (MMMTs) are rare and aggressive neoplasms made up of both carcinomatous and sarcomatous components that primarily appear in the female reproductive tract. The cellular origin of this malignancy has eluded advancements in molecular and immunohistochemical techniques contributing to the limited diagnostic and therapeutic strategies. This case report presents a 41-year-old female with a history of abnormal uterine bleeding and dysmenorrhea who was later diagnosed with an MMMT. This case highlights the importance of considering MMMTs in patients with a long-standing history of abnormal uterine bleeding because the prompt recognition and diagnosis of this condition may lead to an improved overall survival for these patients.

Giant pilomatrixoma in the infraclavicular region following an insect bite.

Pilomatrixoma is a benign skin tumor typically presenting as a hard, slow-growing mass arising from hair follicle matrix cells. While most encountered in children, giant pilomatrixoma seldomly presents in adults. In the present case, a large subcutaneous, nonpainful and slow-growing mass was discovered in the infraclavicular region of a 52-year-old male. Biopsy confirmed the diagnosis of giant pilomatrixoma. Despite its benign nature, tumor size and location can result in significant morbidity and cosmetic deformity. This case highlights the importance of considering pilomatrixomas in patients with a slow-growing mass, especially after an inciting event, such as an insect bite. Timely diagnosis and proper management can result in successful tumor removal with minimal cosmetic compromise.