Obstructed trans-mesenteric hernia in an adolescent: a case report

Acute intestinal obstruction due to a congenital mesenteric defect is very rare. Herein we present a very rare case of acute small bowel obstruction in an adolescent boy as a result of internal herniation through a huge mesenteric defect. A 13-year old boy presented with a picture of acute small bowel obstruction of 2 days duration. Plain x-ray of the abdomen showed dilated small bowel loops with multiple air fluid levels throughout. Patient was resuscitated followed by immediate exploratory laparotomy. Intra-operatively, there was a big mesenteric defect through which a long segment of small bowel was incarcerated and obstructed; fortunately, the herniated loop was viable. Reduction of the bowel was done along with repair of the congenital defect. Patient had a smooth postoperative course

Study of arterial blood gases and pulmonary systolic pressure of children with adeno-tonsillar hypertrophy

Fifty cases with adeno-tonsillar hypertrophy were included in this study, these patients were in the waiting list for adeno-tonsillectomy. Their ages ranged from 2 to 12 years [33 males and 17 females]. The study aimed at evaluation of changes of arterial blood gases [ABG] and pulmonary systolic pressure [PSP] of these cases. Thorough history and physical examination was done with special emphasis on cardiac and chest condition, patients proved to have cardiac or chronic chest problems were excluded. These patients were subjected to: plain x-ray lateral view on the head and neck, electro-cardio-gram [ECG], colored echo-Doppler and arterial blood sample for ABG study. Ten healthy children of matched age were included as a control group, among the attendant of pediatric surgery clinic and listed for surgical intervention. The consent of parents was taken.. As regards to ABG results of the study versus control group were PH [7.33 +/- 0.05 versus 7.38 +/- 0.01], PaCO2 [38.51mmHg. +/- 1.84 versus 37.3mmHg +/- 1.73], PaO2 [77.26mmHg +/- 8.99 versus 78.9mmHg +/- 7.3] and O2 saturation [95.8% +/- 5.89 versus 96.9% +/- 1.11]. The difference of ABG between study and control group was not statistically significant [P value < 0.1,

Isolated nocardiasis presenting as a huge cold abscess: a case report and review of literature

Nocardia, a gram positive higher bacterium, presents usually as pulmonary disease or mycetoma, or rarely as metastatic lesion from lung, or as a primary isolated lesion in skin, subcutaneous tissues, lymphatics, eyes, central nervous system. etc. We report a case, a 50 years old male diabetic, who presented with a rare manifestation of Nocardiasis in the form of an isolated gluteal abscess involving subcutaneous tissue and intermuscular planes that was drained successfully and diagnosis confirmed on culture of pus. Isolated nocardial lesions, a rarity, are seen in immunocompromised host. Our patient, the first of its kind reported from Al Dhahira region of Oman, had only diabetes mellitus [DM] as associated illness and did not have any identifiable source of infection. Diabetes may have caused some compromise in immunity; otherwise he did not have HIV infection or any other cause for depressed immunity. Nocardiasis should be suspected in immunocompromised patients with peculiar mass lesion, strange neurologic presentation and isolated lesions such as gluteal abscess, as in our patient