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This retrospective study reviews 211 patients having sustained a bilateral groin hernia repair during a 3 year period. The procedure was the same for all the patients: via a Pfannensteil approach, a pre peritoneal prosthetic repair is performed, using two ePTFE patches, after resection of the hernial sacs and closure of the parietal gaps. The mean follow up was 2 years. During the post operative course, thirty seven of 211 patients sustained 10 local complications, 9 urethral catheter related complications and 11 residual pain. No prostheses infection or testicular atrophy was observed. Nine patients had recurrences (2.2% of 422 repairs). All the recurrences were due to incorrect technique, eight were successfully re operated on--Expanded PTFE is a reliable prosthetic material, easy to handle and well adapted to preperitioneal hernia repair.

This paper analyzes a publication of wound ballistic from MM. Cooper and Ryan published in British Journal of Surgery 1990, vol. 77 June pp. 606-610 which call "Interaction of penetrating missiles with tissues: some common misapprehensions and implications for wound management". MM. Cooper and Ryan describe interaction of penetrating missiles with tissues, they denounce that they call common misapprehensions in wound ballistic and they try to reconcile engineers works and clinical observations. As a result of this synthesis, a management of war injuries is recommended. Authors of this present paper do a methodical analysis of the British publication and denounce: 1. the experimental method and the "energy-transfer" concept; 2. two contradictories and irreconcilable doctrines promulgated in wound ballistic world which are in one hand supporters of 5.56 bullets shock wave giving distant wounds and iatrogenic mutilations, on the other hand, supporter of wounds treatment without any need to know the weapon; 3. differences between wounds of war and peacetime is sometime more theoretical than real and may give the place to the concept of circumstances surgery.

Wounds of perineal rectum represent an emergency by reason of immediate and secondary seriousness, their ultimate sequelas (15%). From their experience, review of the literature, the authors define a surgical attitude available for civilian injuries: terminal colostomy, large drainage, cautious surgical treatment of rectal injury.

Fifteen cases of severe fractures of the pelvis associated with vascular complications are reviewed. The operational strategy remains controversial when faced with these life threatening traumatic lesions. The chief cause of mortality of these fractures is subperitoneal or retroperitoneal expanding hematoma, the natural course and evolution of which are presently well known and better explored thanks to modern imaging technology. Early-phase intensive care and intervention radiology are partly responsible for a change in the immediate therapeutic attitude. Nonetheless, in hemorrhagic poly-traumatic patients, surgical treatment is still required and remains a method non devoid of pitfalls.

Popliteal entrapment syndrome is not so rare if usually researched by clinical examination. But it is very unusual to find a bilateral aneurysm when you first examine your patient. One of them was complicated by a rupture. The surgical management with bilateral venous grafts is described.