Pseudo-obstruction of the Gastric Outlet Caused by Combined Hyperganglionosis and Ganglioneuromatosis in an adult: Case Report and Literature Review.

Gastrointestinal ganglioneuromatosis is a rare and benign proliferation of both ganglion and Schwann cells, which may present in a variety of clinicopathological characteristics including polypoid, localized and diffuse forms. It is characterized by the presence of a large number of dysplastic ganglion cells or hyperganglionosis. The affected patients are usually children and a number of them have intestinal neuronal dysplasia type B, which may overlap with ganglioneuromatosis.

Chest trauma in children: A local experience.

Background: Chest trauma in childhood is relatively uncommon in clinical practice, and has been the subject of few reports in the literature. This study was undertaken to examine our experience in dealing with chest trauma in children.

Patients And Methods: This was a retrospective study of 74 children who sustained chest trauma, and were referred to King Fahad Hospital in Medina over a two-year period.

Carcinoid tumors of the appendix. Our experience in a university hospital.

Objective: To present our experience of carcinoid tumors of the appendix managed at a university teaching hospital. Complex symptomatology, varied biochemical affections and different surgical therapeutic modalities are discussed.

Methods: The medical records of all the patients who underwent consecutive appendectomies at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from 1994 to 1999 were retrospectively analyzed.

Intestinal obstruction due to mesenteric panniculitis.

This report describes a case of mesenteric panniculitis in a 40-year-old male who presented with features of intestinal obstruction. Computed tomography scan showed a mass in the mesentery of small bowel. Resection of mass with associated small bowel and anastomosis resulted in complete recovery of the patient.

Percutaneous obliteration of duodenal fistula.

High output external duodenal fistula is a difficult condition to treat and despite the advances in nutritional care, morbidity and mortality remain high. Although, non surgical methods (e.g.

Superiority of laparoscopic guided needle biopsy over percutaneous blind needle biopsy in diagnosing hepatocellular carcinoma associated with cirrhosis.

This is a retrospective study of 40 patients clinically suspected of having hepatocellular carcinoma. Group 1 (20) patients underwent laparoscopic Tru-cut needle liver biopsy and Group II (20 patients) underwent percutaneous blind needle liver biopsy. In the first group, in 17 (85%) of the patients, the diagnosis of hepatocellular carcinoma was confirmed by histopathology, direct observation of cirrhosis was seen in 8 (40%) patients, histopathology confirmation of cirrhosis was documented in 6 (35%) patients.

Unusual presentations of injury to the bronchus with literature review.

Two patients with unusual presentation of injury to the bronchi are discussed. The first had a gun shot wound of the anterior left chest with the bullet ricocheting across to the right hemithorax and puncturing the right mainstem bronchus resulting in right massive pneumothorax and subcutaneous emphysema. The second suffered a blunt thoracic trauma from a road traffic accident and presented with bilateral rib fractures and bilateral pneumothoraces treated with bilateral closed thoracostomy tube drainage.

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.

Analysis of laparascopic cholecystectomies in 606 patients: Experience at King Fahad Hospital, Medina.

This is a retrospective study of 606 patients who underwent laparoscopic cholecystectomy at King Fahad Hospital, Medina, Saudi Arabia. The majority of them, 488 (80.5%), were females.

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.

Pattern of cancer in Madina Al-Munawara region.

This is a retrospective study of 2237 histologically proven cases of cancer over a 12 year period from 1981 to 1993. There were 1687 (75.4%) Saudi and 550 (24.

Topical ampicillin for prophylaxis against wound infection in acute appendicitis.

A total of 249 patients, undergoing appendectomy for acute appendicitis, were prospectively randomized into two groups. Group I, comprising 132 patients, received sterile normal saline irrigation to the surgical wound at closure. Alternatively, Group II included 117 patients, who received intraoperative topical ampicillin irrigation of the wound.

Primary closure of breast abscess compared with the conventional gauze packing and daily dressings.

Because of the reported success of primary closure of Skeletal Muscle abscess we conducted a retrospective study of breast abscess treated over a period of 24 months. There were essentially two groups: In one group the abscess cavities were initially packed with gauze and then dressed daily. In the second group, the abscess cavities were primarily closed and a negative suction drain instituted for about five to seven days.

"Silent" abdominal tuberculosis: a report of six cases.

Six cases of "silent" or subclinical abdominal tuberculosis seen in patients who belong to the upper socio-economic class, but with a humble childhood are presented. The patients are usually from the Third World countries and the condition is often missed or mis-diagnosed. This condition is often precipitated by some stressful situation, and the presentation is not typical of the well-known clinical features of abdominal tuberculosis.

Peripheral T-cell lymphoma with unique immunologic features.

Background: The autologous mixed lymphocyte reaction (AMLR) is an important immunoregulatory phenomenon in human immune disorders. The authors have determined the phenotype and assessed the response of malignant lymph node T-cells, from histologically and immunologically proven cases of peripheral T-cell lymphoma, in AMLR and allogeneic mixed lymphocyte reaction (MLR) and studied the secretion of lymphokines.

Methods: The proliferative response, tritiated 3H-thymidine incorporation assay, was used to determine the AMLR and allogeneic MLR of the responding T-cells.

Splenic abscess: Presentation, diagnosis and management.

Splenic abscess is infrequently encountered. This paper reports on the diagnosis and management of six cases from Southern Saudi Arabia. Common presenting features were diffuse abdominal pain and fever.

Management of hydatid cysts of the urinary tract.

Eleven patients with hydatid disease of the urinary tract have been seen in the last 5 years. Seven patients had cysts of the kidneys and 4 had large retrovesical hydatids. Seven of the 8 patients with renal hydatids presented with loin pain and mass.

C-reactive protein in the differential diagnosis of the acute abdomen, especially acute appendicitis.

Serum C-reactive protein (CRP) was qualitatively determined before surgery in 189 patients undergoing appendicectomy. The sensitivity, specificity, negative predictive value and overall accuracy of CRP were assessed: CRP had a high specificity (76.3%) but a sensitivity of only 39.

Pattern of primary gastrointestinal tract cancer in the southern province.

Two hundred thirty-four cases of primary gastrointestinal tract malignancy were diagnosed at the histopathology laboratory of Asir Central Hospital over a four-year period, from 1987 to 1990. The current study is a retrospective analysis of these cases regarding rank orders, distribution according to nationality, age and sex, primary sites affected and the histopathologic pattern. Eighty-eight percent of our cases were Saudi and 12% were non-Saudi nationals.

Hydatid disease of the urinary tract: evaluation of diagnostic methods.

Eight patients with histologically proven hydatid disease of the urinary tract underwent eosinophil count, ultrasonography (US) and computed tomography (CT). The findings were compared with those in 8 age-matched controls with simple renal cysts. Eosinophilia was not significantly different in the 2 groups.

Hydatid disease of the liver: evaluation of ultrasound and computed tomography.

We have evaluated computed tomography (CT) and ultrasonography (US) in 41 patients with hepatic hydatid disease. CT was diagnostic in all patients, while US performed on 36 patients was diagnostic in 34. In the remaining two cases, heavy calcification in one and a large amount of intracavitary air in the other prevented accurate diagnosis.