Mucus containing cystic lesions "mucocele" of the appendix: the unresolved issues.

Background: Mucocele of the appendix is a rare condition, the pathological classification and management strategy of which have not been standardized yet.

Aim: To report on our management of appendiceal mucocele, highlighting the pitfalls and possible means for avoiding them.

Materials And Methods: Our registries were reviewed to retrieve cases of appendiceal mucocele, encountered in the period from July 2008 to May 2013.

Drainage of pancreatic pseudocysts. The importance of cyst wall biopsy in the recent era.

Objective: While open internal drainage has been the standard treatment for pancreatic pseudocysts, less invasive techniques which pay little attention to cyst wall biopsy, are becoming popular. The aim of this study is to report on our experience in draining pancreatic pseudocysts and probe the necessity or otherwise of obtaining a wall biopsy at drainage.

Methods: Operation theatre registry, operation log books and medical records at Aseer Central Hospital, Abha, Kingdom of Saudi Arabia, were reviewed to retrieve the clinical details of patients with pancreatic pseudocyst who required a drainage procedure in a 13 years period from August 1989 to November 2002.

Lessons to be learned: a case study approach. Malignant melanoma of soft tissue.

Malignant melanoma of soft tissue, also called clear cell sarcoma (CCS) of tendons and aponeuroses, presents as a soft tissue mass, usually in the lower extremity of young females. We report two cases of CCS of the upper extremity--in a Korean and a Saudi Arabian girl. Because of the presence of melanin, melanosomes, S-100 protein and the tendency for regional nodal metastases, it has been suggested that this entity be considered a melanoma rather than a soft tissue sarcoma.

Carcinoid tumourlets associated with diffuse bronchiectasis and intralobar sequestration.

Innumerable carcinoid tumourlets may develop within pulmonary lobes should there be scarring from intralobar sequestration; these tumourlets may, in turn, be the cause of chronic lung disease. This report documents the incidental detection of multifocal carcinoid tumourlets in the lung of a 65-year-old man who had repeated episodes of lung infection, progressive dyspnea and haemoptysis; he lived at high altitude. The left lower lobe of the lung was resected surgically, during which procedure an aberrant systemic arterial supply was noticed.

Traumatic diaphragmatic hernia: an Asir region (Saudi Arabia) experience.

Ten patients (nine males, one female), seen at the Asir Central Hospital of South-Western Saudi Arabia with proven traumatic diaphragmatic hernia between 1987 and 1997, were reviewed retrospectively. The mean age was 29.6 years, range 5 to 50 years.

Gall bladder disease and ABO blood group.

Because it had been shown that an elevated total serum cholesterol was associated with phenotype A in many western European and Japanese populations as compared to non-A phenotype, a study was conducted to see whether there was any correlation between ABO blood group and gall bladder disease in our environment. No correlation was found between ABO blood group and gall bladder disease. However, the incidence of gall bladder disease was much higher in females than in males and the incidence was found to be highest in the fourth and fifth decades of life.

Diffuse pulmonary calcinosis and multiple soft tissue calcification in renal failure patient with pathological femoral fracture.

The rare occurrence of diffuse pulmonary calcinosis is described with case illustration of a patient who presented with a pathological femoral fracture during end-stage renal failure. Associated metastatic soft tissue calcification with parathyroid hyperplasia requiring parathyroidectomy was observed. Roentgenologic evidence of hyperparathyroidism with osteitis fibrosa cystica and a high product of the calcium and phosphate values were indications for the parathyroidectomy.

Bronchial carcinoid tumours in southern Saudi Arabia.

Clinical presentation, pathology, surgical management and follow-up of ten bronchial carcinoid tumour (BCT) patients are described. There were five male and five female patients with age range between 5 to 85 years (mean 39.2 +/- 21.

Hydatid cyst disease (Echinococcus granulosus): experience at Asir Central Hospital.

In a six-year period, starting from the commissioning of Asir Central Hospital in 1408 H (1988), 43 cases of hydatid cyst disease caused by echinococcus granulosus seen in Asir Central Hospital were studied. The pattern was not significantly different from other workers' experiences. There was equal sex distribution and the average age was 41.

Perforated duodenal ulcer in Asir central hospital.

In a study of 27 cases of perforated duodenal ulcer seen at Asir Central Hospital over a period of seven years, two patients were females and 25 males. The highest incidence was in the fourth decade and the average age was 36.3 years.

Meckel diverticulum revisited.

Nine cases of Meckel diverticulum seen over a period of four years are presented. Six presented with gangrene, perforation, intestinal obstruction, intraabdominal abscess and pain related to Meckel diverticulum. The remaining three were incidental findings.

Primary mediastinal tumours in the southern region of Saudi Arabia.

A retrospective review of 16 patients operated upon for primary mediastinal tumours was carried out. Anterior mediastinal tumours seen included retrosternal goitre (2), benign cystic teratoma (1), benign thymoma (1), malignant thymoma, spindle cell type (1) and Hodgkin's lymphoma, nodular sclerosing type (1). Mid-mediastinal tumours included bronchial cyst (1), mediastinal granuloma (1), and pulmonary arterio-venous fistula (1).

Gallbladder stones analyzes, bile and wound cultures in cholelithiasis.

One hundred and fifty-two consecutive cases of cholelithiasis were studied. The gallbladder stones were analyzed to determine the constituents, the bile specimens were cultured and correlated with the cultures when wound infection occurred. Mixed gallstones were the commonest type (58.

Spontaneous pneumothorax: A retrospective study of twenty-five patients and literature review.

We present a retrospective study of 25 patients with spontaneous pneumothorax (three current), comprising 16 Saudis (nine males and seven females) and nine non-Saudis (eight males and one female), seen at the Asir Central Hospital, Abha, over a period of 45 months. Almost one-third of the patients (9/25) had no underlying cause discernible by our investigational facilities (chest x-ray, ultrasonography, computed tomographic scan, and flexible bronchofiberscopy). Underlying pneumonia (three patients), pulmonary tuberculosis (two patients), lung abscess (one patient), and congenital bullae (one patient) constituted the etiology in another third of the spontaneous pneumothorax patients.

Empyema thoracis in adults in Saudi Arabia.

Empyema thoracis in adults is an uncommon disease in the Asir region of Saudi Arabia. In a period of seven years (1988 to 1994), 24 patients were treated for empyema thoracis with a hospital incidence of about 23 patients in 100,000 admissions. The community acquired empyemas are more common and less aggressive in non-Saudi patients (six males and one female) as compared to Saudi patients (11 males and 6 females) whose empyemas are mostly nosocomial with an aggressive course.

Thyroid malignancy in multinodular goitre and solitary nodule.

This is a retrospective study of 361 thyroid specimens during a 6 1/2-year period with the objective of investigating the prevalence and pattern of thyroid malignancy associated with multinodular goitre (MNG) and solitary nodule (SN). Fourteen of 172 MNG (8%) and 16 of 105 SN (15.2%) were associated with malignancy, a statistically insignificant difference (P = 0.

Acute appendicitis in females--a clinical study of 366 cases.

A study was carried out on 366 female patients admitted consecutively to Asir Central Hospital with clinical diagnosis of acute appendicitis during the period between 1988 through 1991. In this study, 271 patients had histopathologically proven appendicitis for a diagnostic accuracy of 74%. Ninety-five (26%) patients did not have appendicitis, however, 27 (7.

Value of rebound tenderness in acute appendicitis.

This is a prospective study on 123 randomly selected patients admitted with the diagnosis of acute appendicitis. The value of rebound tenderness as a clinical diagnostic tool was statistically compared to those of some other physical signs; namely guarding, rigidity and Rovsing's sign. Rebound tenderness was found to carry the highest sensitivity (94.

Colo-rectal carcinoma in a tropical African population: an overview report.

Fifty-one selected cases of colo-ano-rectal carcinoma seen in a tropical African population over a period of two decades were reviewed. The patients were divided into three groups. Group A were those cases seen under the age of thirty years, Group B were the resectable rectal carcinoma because they were bulky and occupied the whole of the pelvis.

Head and neck cancer in a referral center in Asir region.

This study looks at the incidence of head and neck cancer in the Southwest Region of the Kingdom of Saudi Arabia (Asir Region). There were a total of 204 newly diagnosed patients seen at Asir Central Hospital between 1987 and 1992; 113 males and 91 females. All were Saudi patients.