ABSTRACT
Background: Acute appendicitis is one of the most frequent reasons for admission to the surgical unit and appendectomy is the most common emergency procedure performed worldwide. The accuracy of diagnosis is not straightforward at all times. A lower negative appendectomy rate [NAR] is regarded internationally as a quality indicator of the treating center
Objective: To determine the diagnostic accuracy of appendicitis by clinical, radiological and histopathological findings. Design: A Retrospective Review. Setting: King Hamad University Hospital, Bahrain
Method: Patients who had appendectomy were included in the study. Data were documented between January 2013 and December 2014. All patients above 14 years of age were included. Incidental appendectomy and appendicitis during pregnancy were excluded from the study
Result: The medical records of 286 patients who underwent appendectomy were reviewed; 187 [65.4%] were males. The mean age was 29.3 years. The negative appendectomy rate [appendix is normal on histopathology] was 29 [10.1 %] while another pathology other than appendicitis was found in one [0.349%]. Twenty-nine patients had a normal appendix, 20 were females. The total perforation rate was 28 [10%]. Complications were encountered in 2 [0.69%] patients. Ultrasound was used in 86 [30.1%] patients and conventional tomography used in 67 [23.43%] cases. The overall accuracy of both clinical and radiological diagnosis was 89.16%. The mean age was 29.3 years
Conclusion: The diagnostic accuracy, in our study, was 89.16%. Clinical diagnosis and radiological imaging, especially in females, could decrease the NAR to an acceptable rate
ABSTRACT
A sixteen-year-old male presented with a history of abdominal pain and vomiting for two days. CT scan revealed ileoileal intussusception and volvulus with free fluids. Exploratory laparotomy revealed gangrenous bowel. Intussusception and volvulus found approximately 10 to 15 cm away from the ileocecal valve. The gangrenous bowel segment was resected using a stapler. The patient had an uneventful recovery. Adult intussusception is rare and differs from pediatric intussusception in presentation, etiology and management. The diagnosis could be delayed due to its non-specific, intermittent and longstanding symptoms. The majority of the cases are diagnosed during emergency laparotomy. A CT scan could be helpful in making the diagnosis earlier. In adults, simple bowel resection is the best modality of treatment. Recently, most surgeons recommend surgical resection, especially in colonic cases, where malignancy is usually present. The extent of resection and reduction of the intussusception is still controversial
ABSTRACT
Background: Obesity is a health and economic risk; individuals with a BMI of >/-30 kg/m2 have 50%-100% increased risk of early death
Objective: To assess the outcomes of advance bariatric procedures namely: Biliopancreatic Diversion [BPD], Mini Gastric Bypass [MGB] and Sleeve Gastrectomy
Design: A Retrospective Study. Setting: King Hamad University Hospital, Bahrain
Method: Eighty-five patients operated for bariatric surgery between July 2012 and August 2013 were reviewed. The following vitals were monitored: excess weight loss, diabetes mellitus [DM], hypertension [HTN], hypercholesterolemia, degenerative joint disease and obstructive sleep apnea [OSA]
Result: Forty-one [95.34%] BPD patients had complete resolution of dyslipidemia, 22 [88%] of DM and 15 [78.94%] of HTN. MGB resulted in complete resolution of HTN in 7 [87.5%] patients and DM in 10 [83.33%]. Dyslipidemia had improved in 2 [66.66%] patients who had Sleeve Gastrectomy and 4 [66.66%] patients with degenerative joint disease
Conclusion: From our experience, bariatric surgery is a feasible and reliable modality for treating obesity and its associated comorbidities. Long-term results may help to enlighten us on the most appropriate procedure for the Arabian Gulf population