Superior mesenteric artery syndrome: a rare cause of upper intestinal obstruction in infants

Superior mesenteric artery syndrome is a rare congenital anomaly seen in infants. We recorded superior mesenteric artery syndrome in a 10 months old infant. He was suffering from vomiting, since birth. Investigations proved that the cause was pressure of the superior mesenteric artery on the third part of the duodenum. After failure of medical treatment, surgery was carried out by joining the upper jejunum to the first part of the duodenum

Pulmonary alveolar microlithiasis; the first reported case in Yemen

Pulmonary alveolar microlithiasis is a rare, chronic lung disease with unclear etiology and pathogenesis, characterized by deposition of minute calculi in the alveolar spaces throughout both lung parenchyma. There are few clinical signs and almost no laboratory abnormalities, and most patients are asymptomatic at time of diagnosis. No definitive therapy exists and patients with advanced lung disease may benefit from lung transplantation. The authors report the first case of pulmonary alveolar microlithiasis in Yemen; A 38-years-old female has complained of dry cough and shortness of breath for more than two months. Her chest radiograph revealed the characteristic sandstorm appearance of diffuse lung micronodular infiltration particularly marked in the mid and lower zones, while the chest computed tomography showed diffuse distribution of micronodular calcific densities most prominent in the middle and lower lung zones with greatest concentration in the subpleural parenchyma and along the broncho-vascular bundles. The corresponding literature was thoroughly reviewed.

Sonographic patterns of goiter among patients from Hadramout, Shabwah and Almahrah governorates, Yemen

The purpose of this study was to identify the sonographic patterns of underlying thyroid diseases that cause enlargement of the thyroid gland in our local communities, in order to improve on the management of this frequent health problem. From April 2008-Januray 2012, the thyroid gland and adjacent parts of the neck of 229 patients [212 females, 17 males] from Hadramout, Shabwa and Almahra governorates- referred to Almadeena medical polyclinic in Mukalla with enlarged thyroid gland- were examined and evaluated using high resolution sonography with a high frequency transducer [7.5-10 MHz]. The patients were categorised according to sex and grouped according to age into decades. The size, shape and echogenicity of the thyroid gland, presence of nodules or lymphadenopathy and color Doppler findings were recorded as criteria for diagnosis and differentiation of the types of underlying thyroid diseases and patients were then classified accordingly. Five types of thyroid diseases were detected; simple goiter, solitary nodular goiter, multinodular goiter, Hashimoto's thyroiditis and Grave's disease. The multinodular pattern was the commonest one [52.8%] followed by Hashimoto's thyroiditis[24.5%] then solitary nodule [19.7%], while Grave's disease and simple goiter were the least causative type of goiter [2.2%, 0.9%]. Females were the most affected [92.6%] with a male to female ratio. of 1:12.5, while young adults [21-40 years] were the most affected age group in the study, followed by late adult group [41-60] while the elderly were the least affected group. Nodular goiter is the most common cause of enlarged thyroid gland in our society but Hashimoto's thyroiditis is relatively common in our communities and should be considered when dealing with patients presenting with an enlarged thyroid gland.