Benign giant retroperitoneal Schwannoma: a case report

Retroperitoneal Schwannoma, or Neurilemmoma, is a rare tumor that originates in the neural sheath from Schwann cells and accounts for only a small percentage of retroperitoneal tumors. Presentation is typically varied and non-specific, ranging from abdominal pain, abdominal mass or an incidental finding, and the diagnosis is quite often difficult, being confirmed by pathological study afterwards. We report a case of benign retroperitoneal Schwannoma which was incidentally noticed by the patient himself as an abdominal mass. Preoperative imaging studies were not helpful for reaching correct diagnosis. Surgical exploration and complete excision of tumor was successful. The histological diagnosis of the tumor was reported as benign Ancient Schwannoma. Postoperative period was uneventful and the patient was discharged with a partial femoral nerve injury characterized by mild antero-lateral thigh and leg anesthesia, and quadriceps muscle palsy: Medical Research Council Rating Score [MRC] - grade 2 muscle power. At ten weeks, his quadriceps weakness improved to MRC grade 3, and the anesthesia, although still present, is slightly improved

Simple closure of perforated peptic ulcer in patients of Al-Gamhouria Teaching Hospital

The majority of the literature on management of perforated peptic ulcers comes from the west. However, this is not necessarily appropriate in the developing world. The aim of this retrospective study was to provide data related to patients with perforated peptic ulcers treated in the surgical department of Al-Gamhouria Teaching Hospital, because of lack of such reported study. Methodology: This retrospective study was carried out at Al-[3amhouria Teaching Hospital. Chart review was conducted for all patients admitted to the surgical department for perforated peptic ulcers during the 4-years period from January 1997 to December 2000. We analyzed the following variables: age at presentation, sex, time of operation after perforation, type of operation, mortality, and pre- and post-operative hospitalization period. During the mentioned 4-years period 58 patients, mean age 38.82 years [ranging from 14 to 75 years], were operated; of them 53 males and 5 females with male to female of 10.6 :1. Most of the patients [47 cases - 81.03%] had perforated duodenal ulcer, whereas the remaining [11 cases - 18.97%] had perforated gastric ulcer. The most affected age group was between 21. 45 years [42 patients - 72.41%]- There was a delay in operation time - mean interval of 26 hours [ranging from 10 - 130 hours]. In majority of the cases [43 of 47- 91.49%, perforated duodenal ulcer- patients and 8 of 11-72.73%, perforated gastric ulcer patients] simple closure of the perforation was used. Post-operative mortality was low [1.72%] - one 45 years old, male, patient admitted within 3 hours since onset of gastric ulcer perforation and underwent partial gastrectomy within 6 hours after perforation. Conclusions: We conclude that emphasis should be placed on shortening the time to surgery, as well as on prompt pre-operative resuscitation. Simple closure remains the selected treatment in the majority of patients, which is simple and safe procedure, followed by eradication therapy for Helicobacter pylori infection