Despite the fact that Lichtenstein is the gold standard for uncomplicated inguinal hernia, the use of mesh in an emergency context remains controversial. Pure tissue repairs have an essential role in the management of incarcerated or strangulated inguinal hernia. To date, there has been little agreement on what is the best surgical technique suitable for emergency hernia surgery. This systematic review aims to evaluate the efficacy and safety of the pure tissue Desarda technique for emergency inguinal hernia repair. A complete search of electronic databases including PubMed/Medline, Web of Science, Embase and, Cochrane library was realized. Newcastle-Ottawa-Scale (NOS) (selection and outcome criteria) was used for quality assessment of included studies. The pooled prevalence of post-operative complications (surgical site infection, hematoma/seroma, chronic pain and, recurrence rate) was estimated. We included 5 studies from different countries. There were 2 randomized controlled trial and 3 observational cohort studies. Totally, there were 199 patients with a mean age of 57.6 years. Male patients were predominant (n = 196). The pooled prevalence of surgical site infection and hematoma/seroma was respectively 16.56% (95% CI: 11.74–22.39) and 12.43% (95%CI: 6.90–20.108). The pooled prevalence of chronic pain and recurrence was respectively 4.35% (95% CI: 1.04–11.47) and 2.10% (95%CI: 0.61–5.14). In summary, Desarda technique is feasible in emergency context with good results. We found any particularly important rate of complications considering the surgery in emergency context. Further studies should be realized to raise the level of evidence.

Spigelian hernia is a rare form of abdominal wall hernias. We report an unusual case of a strangulated spigelian hernia with necrotic contents of the caecum, appendix and terminal ileum in the elderly. An 84-year-old woman, with a history of eight pregnancies, was admitted for bowel obstruction evolving for 7 days. The computed tomography scan showed a strangulated right spigelian hernia. Surgical exploration with an incision centered on the mass confirmed the diagnosis with extensive necrosis of the caecum, appendix and 10 cm of the terminal ileum. A right hemi-colectomy with an ileo-colic anastomosis was performed. The post-operative course was marked by the death of the patient in intensive care due to multi-visceral failure. The occurrence of strangulation with necrosis of the caecum, appendix and terminal ileum in spigelian hernia is extremely rare. It requires early diagnosis and treatment to reduce post-operative morbidity and mortality.

: Introduction: Gallstone disease is a disorder characterised by the formation of stones in the biliary tract. It is the most common biliary condition accounting for more than 98% of all gallbladder and biliary tract disorders. In Africa, previous studies have shown a relative rarity of this condition with a prevalence less than 5%; since it is between 2 and 5 times higher in other continents. A good knowledge of the profile of patient with gallstone disease in a surgical setting could allow to reduce gallstone disease complications and to tailor better the treatment. To our knowledge, there was no previous study about gallstone disease in this region even if there is a high prevalence of metabolic factors of gallstone disease. Methods: This study objective is to describe the epidemiological, diagnostic and therapeutic profile of patients with gallstone disease at the Department of General Surgery of Saint-Louis Hospital (Senegal). It will be a single-centre retrospective cohort study in a period of 5 years (January 2015 – December 2020). The patients’ record of the department of general surgery will be consulted and the patient contacted if there are missing data. Patients with gallstone disease diagnosed with imaging (ultrasonography and/or CT scan) regardless the presentation (asymptomatic, biliary colic, cholecystitis, common bile duct lithiasis, angio-cholitis, pancreatitis) will be included. Adults and paediatric patients will be enrolled. Patient records lacking sufficient data will be excluded. Studied parameters will be epidemiological, clinical, paraclinical and therapeutic aspects. Ethics and dissemination: Anonymity and confidentiality of information collected in patients will be respected. This research protocol will be submitted to the Ethics Committee of our institution for approval. The knowledge of the profile of patients with gallstone disease in a surgical setting could allow to reduce gallstone disease complications and to tailor better the treatment. Finally, it will help to reduce the burden of gallstone disease. Highlights:

Introduction and importance: Meckel’s diverticulum is a rare congenital intestinal anomaly that can cause sometimes serious complications. Our aim is to review the literature on this condition by reporting the clinical case of a young adult with Meckel’s diverticulum complicated by acute intestinal obstruction. Case presentation: this was a 24-year-old young man, operated on for open bladder stones, received for occlusive syndrome. Abdominal CT suggested a flange occlusion. Surgical exploration found a Meckel’s diverticulum creating a flange around the last one. An intestinal resection was performed with direct anastomosis with simple consequences. Clinical Discussion: Meckel’s diverticulum is a rare congenital intestinal anomaly. It is discovered incidentally or in the face of serious complications such as intestinal obstruction. Intestinal resection with one-stage anastomosis emerges as a standard and safe management approach. Conclusion: A Meckel’s diverticulum can be complicated by acute intestinal obstruction mimicking a postoperative flange that can err the diagnosis.