ABSTRACT
Background: Laparoscopic approach for colorectal resections is now very popular. Internal small bowel herniation [SBH] through a mesenteric defect has been recorded especially if the mesentery is not repaired. Although it's rare, it is a severe complication. Lack of postoperative adhesions is one advantage of minimally invasive surgery but it's also responsible for a higher incidence of internal hernias. These patients often present with intermittent abdominal pain or small bowel obstruction with completely normal contrast radiographs. Laparoscopic surgery is a minimally invasive approach with good treatment outcomes and is currently the standard surgery for colorectal cancer in Saudi Arabia
Objective: the aim of our study was to evaluate the incidence and outcome of internal hernias after laparoscopic procedure in King Abdul-Aziz Hospital and Oncology Center
Patients and methods: a total of 372 patients underwent laparoscopic colon resection surgery for colon cancer during the study period from August 2015 to October 2016 in King Abdul-Aziz Hospital and oncology center. Results: our result found that internal hernia was reported 48 times
ABSTRACT
This report is point to patient admitted to our hospital as case of G6PD and dilated cardiomyopathy, with congestive heart failure started on anti-failure and aspirin and need to be admitted on ICU for inotropic support, then on the 2[nd] day the patient developed thrombocytopenia then we stopped aspirin and warfarin started after using of warfarin by one-day patient developed sever thrombocytosis so we consider to start low molecular heparin which improved the platelets count then started to decreased to normal range in 5 days duration after LMH started
ABSTRACT
To evaluate the clinical manifestations, diagnostic features, disease course and response to treatment among Saudi adults with predominantly hepatic Wilson's disease. A retrospective cohort study of 40 adult patients diagnosed with predominantly hepatic Wilson's disease between 1994 and 2008 at King Abdulaziz Medical City, Riyadh was carried out. The diagnosis was based on varying combinations of clinical and laboratory evidence of liver disease, presence of Kayser Fleisher rings, low serum ceruloplasmin levels, elevated 24 hour urinary copper excretion and histopathological findings on liver biopsy. The most frequent clinical presentation was decompensated chronic liver disease in 19 [47.5%], followed by chronic hepatitis in 15 [37.5%] and fulminant hepatic failure [FHF] in 5 [12.5%] patients. Eight [20%] patients with end-stage liver disease had liver transplantation, while 24 [60%] patients followed up on medical treatment for a variable period of 1-12 years showed clinical and laboratory improvement. One patient was lost early in follow up. Eight [20%] patients died during the study period, 5 with FHF, and 2 with advanced hepatic and neurological disease and one seven years after liver transplantation. Mortality rate was 100% in FHF without liver transplantation. A predominantly hepatic Wilson's disease has varied clinical presentations with decompensated chronic liver disease being the most common among adult patients. Majority of the patients show stabilization of the disease on medical treatment. FHF in Wilson's disease has a grave prognosis without liver transplantation, the later remains a definitive treatment option for decompensated cirrhotics and patients with FHF.
ABSTRACT
Variceal bleeding is a major event in the natural history of end-stage liver disease with a subsequent high mortality rate. Non-selective [beta-blockers are currently the drugs of choice for preventing first variceal bleeding. Endoscopic rubber band ligation of high risk varices features as a first line option if cirrhotic patients cannot tolerate beta-blockers. Despite adequate beta-blockade, some patients may still present with variceal bleeding. The effect of carvedilol, a non-selective beta and alpha-1 receptor-blocker, on lowering portal pressure has been investigated in several clinical trials and found to be superior to propranolol in both acute and chronic hemodynamic studies. Recently, carvedilol has also been compared with band ligation for primary prophylaxis against variceal bleeding with equivalent results to band ligation. Patient tolerance to carvedilol in advanced liver disease remains a source of concern. This review examines the place of carvedilol as an alternative to the currently recommended pharmacological therapy in prophylaxis against variceal bleeding