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With an increasing incidence of sepsis, increasing use of the emergency department by populations at risk, and an increase in time spent in the emergency department awaiting hospital admission, emergency medicine practitioners are offered a valuable opportunity to make a significant difference in the fight against sepsis. By administering appropriate antibiotics in a timely fashion, removing possible sources of infection, practicing early goal-directed hemodynamic optimization, using lung-protective ventilation strategies, and judiciously using corticosteroids and intensive insulin therapy, the goal of reducing mortality from sepsis can be achieved.

Spigelian hernias, which represent <2% of all hernias of the vellum abdominis (abdominal wall) anterior, can be a diagnostic challenge for clinicians. Noninvasive imaging techniques, including ultrasonography (US) and computerized axial tomography (CAT), substantially complement clinical inferences based on interrogation and physical examination. Successful definitive care mandates comprehension of the regional, topographical, and visceral anatomy in axial, coronal, and transverse planes. Reported herein is the successful use of a bilayered prosthetic patch, advantageous because of its unimodular and biplanar configuration, to perform a tensionless herniorrhaphy.