Ultrasound diagnosis of cephalopagus conjoined twin pregnancy at 29 weeks

The authors report a case of a cephalopagus conjoined twin that was diagnosed at 29 weeks of gestation despite the mother having had two ultrasounds done previously. The fetus had one head and face, fused thoraces, common umbilicus but had two pelvises and two sets of genitalia. The fetus had four normally formed legs and arms

Twelve years of experience treating Spigelian hernia

Background and aims. A Spigelian hernia (SH) is an acquired ventral hernia that most commonly occurs in the Spigelian belt. Patients may experience pain or a bulge in the abdominal area, but in most cases there are no symptoms. If left untreated the hernia may become strangulated, which could lead to bowel obstruction. Material and methods. We reviewed 28 surgical patients with SH between January 2002 and December 2013. We evaluated the incidence of complications, recurrences, and the length of hospital stay with comorbidities, body mass index, clinical presentation, and operative techniques. Results. The 28 patients included 10 males and 18 females, with a mean age of 67 years. Seven patients (26.9%) received emergency operations, and the remaining patients received elective operations. An "open-direct" operative approach was used in 16 cases and a laparoscopic approach in 12. The overall complication rate was 7.6% and the recurrence rate was 3.8% with a median follow-up of 3 years. The median hospital stay was 1 day (range, 1-7). Only the presence of local complications at diagnosis showed a significant impact on length of hospital stay. None of the considered variables had a significant impact on hernia recurrence. Conclusion. No differences were noted among the operative techniques, wound infections, complications rate, and length of hospital stay. Laparoscopy seems to cause more early postoperative pain that reverses in about 2 weeks