Cutaneous Rosai-Dorfman Disease presenting as a flank swelling.

Rosai-Dorfman disease (RDD) is primarily a disease of lymph nodes caused by accumulation of excessive histiocytes. The extra-nodal sites are simultaneously involved in almost half the cases. However, presentation with isolated extra-nodal sites is uncommon and disease confined to skin and soft tissues is a rare entity.

Outcome of open Tenckhoff catheter insertions: 5 years experience in a major tertiary centre in central Saudi Arabia.

Background: Continuous ambulatory peritoneal dialysis (CAPD) has become a popular and established form of renal replacement therapy in patients with end-stage renal disease (ESRD). The objective of this study was to analyse the outcome of open Tenckhoff catheter insertions in patients with ESRD in term of catheter related complications.

Methods: From December 2006 to November 2011, 337 Tenckhoff catheters were placed in 305 patients with ESRD for CAPD, by general surgeons in King Saud Medical City, Riyadh, Saudi Arabia.

An experience of laparoscopic sleeve gastrectomy in obese, morbidly obese, and super morbid obese patients.

Objective: To report experience with laparoscopic sleeve gastrectomy (LSG) in obese, morbidly obese, and super morbid obese patients, and to evaluate comparative efficacy of LSG among these patient groups.

Methods: A total of 147 patients underwent LSG between March 2008 and December 2011 at the Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Patients were grouped according to the preoperative body mass index (BMI) into obese (35-39.

Management of appendiceal abscess. A 10-year experience in Central Saudi Arabia.

Objective: To study the outcome of patients with appendiceal abscess (AA) following immediate operative and non-operative management in terms of complications and hospital stay.

Methods: Medical records of all adult patients treated for AA between July 2002 and June 2011 in the Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia were reviewed. We identified 2 main groups of patients with the diagnosis of AA.

Cholecystectomy without intraoperative cholangiogram in gallstone pancreatitis.

Objective: To determine the long term outcome of cholecystectomy without intraoperative cholangiogram (IOC) in patients recovering from acute gallstone pancreatitis with normal preoperative liver function tests and imaging.

Methods: The medical records of all patients who underwent cholecystectomy without IOC for gallstone pancreatitis at King Saud Medical City, Riyadh, Saudi Arabia between January 2005 and December 2009 were studied retrospectively. Patients with severe pancreatitis and those who had preoperative endoscopic retrograde cholangio-pancreatography (ERCP) were excluded from the study.

Extensive retroperitoneal hematoma in blunt trauma.

Objective: To report our experience of managing extensive retroperitoneal hematoma (RH) in patients with blunt trauma and to determine any associated factors affecting causation and mortality.

Methods: In this retrospective observational study, patients diagnosed with extensive RH following blunt trauma admitted to King Saud Medical Complex, Riyadh, Kingdom of Saudi Arabia between January 2004 and December 2009 were included. Patient data were explored for injury severity score (ISS), associated injuries, location of hematoma, amount of blood transfusions, coagulation profile, operative management, hospital stay, and mortality.

Pseudomyxoma peritonei. Presenting as a localized perforation of the cecum.

Pseudomyxoma peritonei (PMP), also known as jelly belly, is a rare condition with mucinous material spread throughout the abdomen. It can arise from the appendix, colon, or even a teratoma. The documented incidence is one per million per year.

Impact of comorbidity on outcome among acute non-traumatic surgical patients. Evaluation of Charlson comorbidity index.

Objective: To determine the prevalence of comorbid conditions among acute non-traumatic general surgery patients. To assess the impact of comorbidity on outcomes and evaluate the effectiveness of using Charlson comorbidity index (CCI) in these patients.

Methods: All acute non-traumatic general surgery patients admitted to King Saud Medical Complex, Riyadh, Saudi Arabia, between January 1, 2007 and December 31, 2007 were included (n=1296).

Gastrointestinal tract bleeding in intellectually disabled adults.

Background: Gastrointestinal (GI) tract bleeding in intellectually disabled (ID) individuals presents peculiar diagnostic and management difficulties. This study details the experience of a tertiary referral teaching hospital in Central Saudi Arabia in the management of GI bleeding necessitating admission in ID adults.

Patients And Methods: Prospective collection of data was taken on consecutive ID adults admitted for GI bleeding from January 2000 through December 2004.

Excision with or without primary closure for pilonidal sinus disease.

Objective: To evaluate the outcome of excision with or without primary closure in the management of chronic pilonidal sinus (PNS) disease.

Methods: Between July 2002 and November 2006, a randomized trial was conducted in the Department of General Surgery, Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia. All the patients who presented with chronic natal cleft PNS disease were included in the study.

Squamous cell carcinoma of colon and rectum.

Primary squamous cell carcinoma SCC of the colon and rectum is a rare malignancy. Less than 100 cases have been reported in literature. We report 2 cases of pure SCC involving the rectum and sigmoid colon.

Suture versus mesh repair for incisional hernia.

Objective: To compare suture with mesh repair, for incisional hernia in terms of early and late outcomes.

Methods: We reviewed the records of all the patients who presented with primary or recurrent incisional hernia in the Department of General Surgery, Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia, from January 2000 to December 2004. We divided patients, who underwent repair, in 2 groups: Group A (suture repair) and Group B (mesh repair).

Transabdominal gastro-esophageal devascularization and esophageal transection for bleeding esophageal varices after failed injection sclerotherapy: long-term follow-up report.

Background: Management of continued bleeding from esophageal varices despite adequate injection sclerotherapy remains one of the medical and surgical dilemmas. Transabdominal gastroesophageal devascularization and esophageal transection (TGDET) is considered an effective and safe procedure for such patients.

Aim: This study aimed at presenting continued evaluation of TGDET.

Surgery for acute abdominal conditions in intellectually-disabled adults.

Background: Intellectually-disabled patients with acute abdominal conditions are susceptible to late diagnosis and adverse outcome due to impaired communication, altered behaviour, neurological impairment, associated congenital anomalies, variable reaction to pain and drugs and various difficulties in perioperative management. The present study aims to present the experience of surgery for acute abdominal conditions in intellectually-disabled patients. Various difficulties encountered during the management are highlighted and measures to overcome these problems are discussed.

Spectrum of general surgical problems in the developmentally disabled adults.

Objective: This study highlights the spectrum of general surgical problems necessitating admission on intellectually disabled adult patients. Problems encountered in the management and the ways to overcome various difficulties are highlighted.

Methods: Prospective collection of data on 63 consecutive developmentally disabled adult patients admitted to the Department of General Surgery, Riyadh Medical Complex (RMC), Riyadh, Kingdom of Saudi Arabia for various indications from January 2000 through December 2004.

General surgical problems encountered in the Hajj pilgrims.

Objective: The study was conducted to evaluate the pattern of general surgical admissions for future planning of staff, cost and other needs of these hospitals.

Methods: The study was conducted in 2 major hospitals in the Holy Shrine in 2 consecutive Hajj years 1423, 1424 (2003, 2004). All general surgical admissions, except those who died in the emergency room or were received dead, were included in the study.

Castleman disease presenting as obstructive jaundice.

A 48-year-old Saudi male was admitted with features of obstructive jaundice. Endoscopic retrograde cholangiopancreatography showed stricture in distal common bile duct CBD. Computed tomography scan revealed lymphadenopathy along CBD and in porta hepatis.

Initial factors predicting rebleeding and death in bleeding peptic ulcer disease.

Objective: Bleeding peptic ulcer constitutes approximately half of the cases admitted with upper gastrointestinal bleeding. Although the bleeding episode stops spontaneously in most of them, rebleeding occurs in as much as 10-30% of them and has a mortality rate of 5-10%. In this study, we have evaluated the possible significant predictors associated with this adverse outcome.

Outcome of laparoscopic cholecystectomy in acute biliary pancreatitis.

Objective: To evaluate the efficacy, safety, and timing of laparoscopic cholecystectomy in the management of mild to moderate cases of acute biliary pancreatitis.

Methods: The medical records of 158 patients admitted to Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia (KSA) from July 1998 to December 2001 were retrospectively reviewed. Acute biliary pancreatitis was diagnosed in patients who presented with abdominal pain with serum amylase level 3 times the normal limits in the absence of hypercalcemia or hyperlipidemia and presence of gallstones on ultrasonography.

Role of ultrasonography, computed tomography and diagnostic peritoneal lavage in abdominal blunt trauma.

Objective: To compare the diagnostic accuracy of diagnostic peritoneal lavage (DPL), ultrasonography and computed tomography in the management of blunt abdominal trauma.

Methods: A retrospective review of the charts of 233 patients with blunt abdominal trauma necessitating admission to Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia was carried out over a 2 year period (January 2000 to December 2001). The diagnostic yields of DPL, ultrasound and computed tomography were analyzed.

Incidence of differentiated cancer in nodular goiter.

Objective: The study aims to determine the incidence of differentiated thyroid cancer in surgically treated thyroid nodules and to study its clinical and pathological aspect. The objective was to formulate a uniform departmental policy for the most appropriate surgical management of this potentially curable disease.

Methods: This is a prospective clinicopathological study carried out at the Department of General Surgery, Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia, from January 1996 through to December 2000.