The definition of complicated appendicitis has been an area of concern due to the absence of any universal consensus. Complicated appendicitis often means perforation of the appendix with either peritonitis, abscess, or mass formation. The diagnosis of complicated appendicitis is another area where there is no consensus and there is no one investigation that can diagnose this condition. Diagnosis often involves the use of clinical examinations, blood investigations, and imaging modalities. In this chapter, we will look at the definition and diagnosis of complicated appendicitis.

This study was investigated to evaluate the level of malondialdehyde, ascorbic acid and membrane potential among diabetic patients in Owerri.100 diabetics patients and 100 apparently healthy subjects between the ages of 45- 60 years admitted to General Hospital Owerri were selected in this study. Fasting venous blood was collected and was used for the determination of malondialdehyde, ascorbic acid and membrane potential. The results obtained revealed that the levels of malondialdehyde was increased in diabetics when compared with the control. While membrane potentials and ascorbic acid were significantly decreased in diabetics patients when compared with the control at P<0.05. This could probably imply increase of malondialdehyde and decreased membrane potential as well as decreased ascorbic acid could lead to oxidative stress.

The management of emergency groin hernias is difficult due to the absence of any consensus and the surgical management is tailored by the treating surgeon. Emergency groin hernias include incarcerated and strangulated inguinal and femoral hernias and they carry a high morbidity and mortality. The treatment of emergency groin hernias is usually performed with sutured repairs like Shouldice, Bassini, Darning and the Desarda technique. Hernia repairs with mesh can also be safely performed if there is no or minimal contamination of the wound. The laparoscopic repairs like the Transabdominal preperitoneal (TAPP) and Total Extraperitoneal (TEP) can be performed but require training and equipment and is not recommended for the management of emergency groin hernia. In this review we will look at the management of emergency groin hernias.

Appendicular abscess is a complication from perforation of the appendix, and it is seen in 10% of cases of acute appendicitis. It is diagnosed by clinical examination, the presence of leukocytosis and imaging modalities like ultrasound or computerized tomography. The treatment is usually conservative with intra-venous fluids, antibiotics and percutaneous drainage of the abscess. The introduction of laparoscopic surgery has seen a move towards immediate appendectomy. Interval appendectomy is no longer a routine and is only performed for patients who present with recurrent symptoms. We have conducted this narrative review article to look at the various management options for appendicular abscess.

Benign gastric outlet obstruction is a rare condition that is seen and its causes obstruction of the pylorus. Peptic ulcer disease accounts for the most common cause for benign gastric outlet obstruction. The diagnosis is confirmed by imaging modalities like upper gastrointestinal contrast series or computerized tomography. The treatment of benign gastric outlet obstruction is divided into endoscopic or surgical treatment. Endoscopic ballon dilatation is the most common primary treatment for benign gastric outlet obstruction with surgical therapy being reserved for failure of endoscopic treatment. Surgical therapy involves performing a vagotomy and a drainage procedure like a pyloroplasty or gastrojejunostomy. We have conducted this review article to look at the diagnosis and treatment of benign gastric outlet obstruction.

Femoral hernias are a rare presentation of groins hernias, but it is associated with an increased risk of complications like strangulation and obstruction. It is seen in older patients and the diagnosis is usually late. The surgical treatment of femoral hernias can be divided into open femoral hernia repairs that include the low, inguinal or preperitoneal approach. The laparoscopic methods include the transabdominal preperitoneal (TAPP) and the total extraperitoneal (TEP) repairs. As there is no consensus on what the best surgical procedure for femoral hernias is, we have conducted this review article to look at the surgical management of femoral hernias.

Open inguinal hernia repairs are a common general surgical procedure, and it can be divided into mesh-based repairs and sutured based repairs. Mesh-based repairs are the most popular open inguinal hernia repair with the Lichtenstein repair being the most common surgical procedure. The sutured based repairs are not as commonly performed with the Shouldice repair being the most popular repair, but the Desarda repair is slowly emerging as a viable sutured based inguinal hernia repair. We have conducted this review article to look at the varies types of mesh based and sutured based repairs for open inguinal hernia repair including their complications and recurrence rate. We also looked at the effect of chronic pain and the role of antibiotic prophylaxis in open inguinal hernia repair.