Toe tourniquet syndrome.

Toe tourniquet syndrome refers to external, mechanical, circumferential constriction of the toes. We report a series of 4 infants with toe tourniquet syndrome from Saudi Arabia who presented during wintertime with very similar symptoms (approximately 48 hours of inconsolable crying and irritability), similar involved region (toes), and similar constricting agent (hairs). Immediate removal of the hair fibers was carried out in all patients, fortunately followed by fast healing with no signs of tissue necrosis.

Medical and surgical management of fecal incontinence after repair of high imperforate anus anomalies.

Objective: To report the medical and surgical management of fecal incontinence in children after repair of high imperforate anus.

Methods: Thirty-seven children with fecal incontinence post repair of high imperforate anus were recruited between January 2000 and July 2007 at Aseer General Hospital, Abha, and Alhada Military Hospital, Taif, Kingdom of Saudi Arabia. The decision for surgery (dynamic graciloplasty) was based on the degree of incontinence and failure to respond to medical treatment.

Congenital esophageal stenosis associated with esophageal atresia: new concepts.

Congenital esophageal stenosis (CES) is suspected by a fixed intrinsic narrowing of the esophagus that affects the normal swallowing mechanism. The diagnosis is only confirmed by histopathologic picture, which may show fibromuscular disease (FMD) or tracheobronchial remnants (TBR). The latter involves ciliated pseudo stratified columnar epithelium, seromucous glands or cartilage each alone or in combination.

Esophageal atresia with tracheoesophageal fistula and early postoperative mortality.

Background: Several recent reports showed that associated anomalies represent the main cause of postoperative mortality in infants born with esophageal atresia (EA) and/ or tracheoesophageal fistula (TEF) Our observations present additional causes of mortality to the above mentioned. The aim of this study is to identify the major causes of early postoperative mortality in cases of EA and/or TEF in our setup. The ongoing preoperative classifications predicting mortality will be also used for comparison.

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.