Research Article
Ultrasound-Guided Quadratus Lumborum Block Versus Local Infiltration Anesthesia for Inguinal Herniorrhaphy:
A Randomized Controlled Trial
Yong Liu*
Issue:
Volume 14, Issue 2, April 2026
Pages:
21-29
Received:
18 February 2026
Accepted:
27 February 2026
Published:
10 March 2026
Abstract: Background: Quadratus lumborum block (QLB) has been reported as an innovative analgesic procedure for enhanced recovery after inguinal herniorrhaphy. However, it has never been compared with local infiltration anesthesia (LIA) as the sole anesthetic technique in inguinal herniorrhaphy. This study aimed to compare the anesthetic efficacy of QLB and LIA for inguinal herniorrhaphy. Methods: A total of 70 patients undergoing elective inguinal herniorrhaphy were randomly assigned to receive either QLB or LIA. The primary outcome was the area under the curve (AUC) of the pain numeric rating scale (NRS) during surgery. Secondary outcomes included anesthesia efficacy, consumption of additional local anesthetics for rescue analgesia, level of intraoperative traction reaction, postoperative pain scores at rest and during movement, and adverse side effects. Results: The QLB group had a significantly higher AUC for intraoperative NRS scores than the LIA group (15.7 ± 3.1 vs 13.1 ± 3.6, 95% CI for the difference: 1.23 to 4.17, P=0.002) and required a greater volume of rescue local anesthetics (11.0 ± 7.6 mL vs. 5.7 ± 6.4 mL, 95% CI for the difference: 1.05 to 9.55, P=0.02). However, the QLB group had lower scores for visceral traction reaction [median 2.0 (interquartile range, IQR 2.0 to 2.3) vs. 2.0 (IQR 2.0 to 3.0), 95% CI for the median difference: -0.82 to -0.05, P=0.026] and lower resting NRS pain scores at 12 h postoperatively. Conclusions: Both QLB and LIA can provide sufficient analgesia for inguinal herniorrhaphy without the need for conversion to other anesthetic methods. LIA is more effective in controlling intraoperative pain and reducing the consumption of rescue local anesthetics, while QLB is associated with milder peritoneal traction reaction and better postoperative analgesia at 12 h after surgery. The combination of LIA and QLB is hypothesized to be a more optimal anesthetic choice for inguinal herniorrhaphy, which requires further prospective clinical research to verify this assumption.
Abstract: Background: Quadratus lumborum block (QLB) has been reported as an innovative analgesic procedure for enhanced recovery after inguinal herniorrhaphy. However, it has never been compared with local infiltration anesthesia (LIA) as the sole anesthetic technique in inguinal herniorrhaphy. This study aimed to compare the anesthetic efficacy of QLB and ...
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Case Report
Rare Presentation of a Primary Mesenteric Cystadenocarcinoma: Surgical Management
Rajib Kumar Majumdar,
Yadavalli Sri Venkata Raviteja*
Issue:
Volume 14, Issue 2, April 2026
Pages:
30-34
Received:
23 January 2026
Accepted:
5 March 2026
Published:
17 March 2026
DOI:
10.11648/j.js.20261402.12
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Abstract: Primary cystadenocarcinoma of the mesentery is an extremely rare malignant cystic epithelial tumor and represents the malignant spectrum of mesenteric mucinous cystic neoplasms. Due to its rarity, fewer than 25 cases have been reported in the literature, and the clinical characteristics, diagnostic features, and optimal management strategies remain poorly defined. Patients usually present with nonspecific symptoms related to mass effect, including abdominal pain, abdominal distension, nausea, vomiting, constipation, or a palpable abdominal mass, often mimicking ovarian or gastrointestinal tumors. Preoperative diagnosis is particularly challenging because radiological findings are not pathognomonic and tumor markers have limited diagnostic value. We report a rare case of primary mesenteric cystadenocarcinoma in a 20-year-old female who presented with progressive abdominal distension, abdominal pain, nausea, vomiting, constipation, and exertional shortness of breath. Clinical examination revealed a large abdominal mass. Contrast-enhanced positron emission tomography–computed tomography demonstrated a large lobulated abdominopelvic mass with internal septations and heterogeneous enhancement, producing significant mass effect including bilateral ureteric dilatation and hydronephrosis. However, the exact origin of the lesion could not be determined preoperatively. Exploratory laparotomy revealed a large cystic mass arising from the mesentery with dense adhesions to the colon. Complete surgical excision was performed without rupture. Histopathological examination confirmed papillary mucinous cystadenocarcinoma of mesenteric origin. This case highlights the diagnostic difficulty associated with mesenteric cystic malignancies and emphasizes that complete surgical excision remains essential for definitive diagnosis and management.
Abstract: Primary cystadenocarcinoma of the mesentery is an extremely rare malignant cystic epithelial tumor and represents the malignant spectrum of mesenteric mucinous cystic neoplasms. Due to its rarity, fewer than 25 cases have been reported in the literature, and the clinical characteristics, diagnostic features, and optimal management strategies remain...
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