Assessing predictors of outcome in necrotizing fasciitis at Jordan University Hospital

Necrotizing fasciitis is a life threatening infection characterized by rapidly developing necrosis of the subcutaneous tissue and fascia with subsequent gangrene of the overlying skin. Necrotizing fasciitis [NF] is increasingly being diagnosed at Jordan University Hospital [JUH] with an apparent difference in the bacteriology of this disease. The aim of this study was to examine the presentation, etiology, course of the disease, treatment, and to identify the variables that are associated with high mortality. Information on the presentation, etiology, treatment, pathology and complications in all cases diagnosed with necrotizing fasciitis from January 1987 to January 1998 A total of 23 patients underwent surgical exploration for necrotizing fasciitis during the study period. Six variables identified that significantly increased the risk of death from necrotizing fasciitis: Age above 60 years, female sex, perineal location, delayed operative management, white blood cell count more than 30,000 cell per mm[3] and infection mainly with Gram negative [G-ve] bacteria species. This study suggests that necrotizing% fasciitis is a serious and potentially fatal infection particularly in old, female patients presenting with perineal infection, high WBC count, and Gram negative [G-ve] bacterial isolates. Early diagnosis, aggressive initial debridement and redebridement in addition to adequate nutritional support and antibiotics are the mainstay of treatment

Parotid tumours at Jordan University Hospital

This is a retrospective study of 27 patients with parotid tumours treated surgically at the Jordan University Hospital during a four year period [May 1983 to April 1987]. There were 20 [74%] benign and seven [26%] malignant tumours. Pleomorphic adenoma, the most common of the tumours, was encountered in 15 patients. Of the malignant variety, mucoepidermoid carcinoma was found in three out of the seven cases. Although this study is small, we could observe the early age of onset and the high incidence of malignancy

Spontaneous transverse mesocolic hernia with transverse colon obstruction

A case of spontaneous transverse mesocolic hernia, associated with secondary amyloidosis, is presented. The points of particular interest are: [1] The presentation of the patient with chronic intermittent colonic obstruction, [2] The unusual mobility of the right colon, [3] The association of secondary amyloidosis with chronic intermittent obstruction and symptomatic improvement after repair of the hernia. Hernias through the mesentery are rare. Herniation through the mesentery of transverse mesocolon accounts for only 16 percent of the cases[1]. Fewer than 85 spontaneous transverse mesocolic hernias have been reported and most of them before 1949[2-4]. This patient presented with chronic large bowel obstruction associated with generalized amyloidosis

Transverse testicular ectopia

A case of transverse testicular ectopia is reported. The value of preoperative diagnosis of this condition has been discussed. It allows for a planned operative management. A brief review of the medical literature is presented. Transverse ectopia testis is a congenital abnormality in both testicles descend through the same inguinal canal of the same side of the scrotum It is one of five recognized ectopic positions of the testis [interstitial, femoral, perineal, transverse, and pubopenile, in descending order of incidence. Since Halstead's first case in 1907, forty cases has been reported in the English literature and found an additional 44 cases. We used the med-line and index medicus for review of the German, Franch, Italian, Spanish and Russian literature and found 12 additional cases The subject of this report is an additional case of transverse testicular ectopia which was diagnosed before surgical repair of an associated recurrent inguinal hernia