Dissecting aneurysm of the internal carotid artery as a complication of facial bone trauma

The involvement of the internal carotid artery in dissecting aneurysm is rarely reported in the literature and may occur as a complication of trauma, surgery, and other medical conditions. We report a case of a 22-year-old male who was involved in a motor vehicle accident with associated multiple orthopedic and maxillofacial fractures. During surgical management, the patient was incidentally diagnosed with a dissecting aneurysm involving the right internal carotid artery

Mycotic aortic aneurysm treated by endovascular aneurysmal repair [EVAR] [first case report from Oman]

Mycotic aortic aneurysm is rare but life threatening disease. Endovascular aneurysm repair [EVAR] has become an established procedure for the treatment of many infrarenal aortic aneurysms

Although EVAR is obviously less invasive than open surgical repair but it is not without complications. Lower extremity ischemia is a known complication of endovascular abdominal aortic aneurysm repair [EVAR]. Limb occlusion, embolism or access related problems are the main causes. We hereby describe the first case of EVAR of infra renalmycotic aortic aneurysm in the history of Sultan Qaboos University Hospital Oman. A 67 years old lady known to have diabetes mellitus and hypertension admitted with fever and abdominal pain. On further evaluation found to have 4 cms infra-renal mycotic abdominal aortic aneurysm treated by EVAR but procedure was complicated by lower limb ischemia due to thrombosis at the puncture site which was successfully treated by aspirating thrombus and ischemia was relieved

Solid pseudopapillary neoplasm of the pancreas: a case report with review of the diagnostic dilemmas and tumor behavior

Solid pseudopapillary neoplasm of the pancreas is a rare tumor of the pancreas often detected initially on imaging. Of uncertain histogenesis, it has a low-grade malignant potential with excellent post-surgical curative rates and rare metastasis. Despite advances in imaging, pseudocysts and other cystic neoplasms feature in the differential diagnosis. Pathological and/or cytological evaluation remains the gold standard in reaching a definitive diagnosis. On morphology alone, other primary pancreatic tumors and metastatic tumors pose a diagnostic challenge. Recent advances in immunohistochemical characterization have made the histopathologic diagnosis more specific and, in turn, shed light on the likely histogenesis of this rare tumor. We report a case of solid pseudopapillary neoplasm of the pancreas that was suspected on radiology and diagnosed intraoperatively on imprint cytology guiding definitive surgery. The diagnostic dilemmas are reviewed.

Blunt cerebrovascular injuries: a review of the literature

Blunt cerebrovascular injuries [BCVI] have been a topic of interest to many researchers worldwide as evidenced by the vast amount of available literature. The interest in these rare injuries is probably due to the significant possibility of mortality and morbidity amongst patients who sustain them, when the employment of radiological screening methods could prevent such an outcome. Recognition of these injuries is the most important step towards prevention of adverse outcomes. We present a comprehensive review of the literature regarding the mechanism of injury, imaging, management, and complications of BCVI. Articles were identified through a search of MEDLINE and the Cochrane Central Register of Controlled Trials using the keywords Blunt; Vascular; Carotid; Vertebral; Trauma; Stroke; Management, and Endovascular. The search was limited to humans and articles in English

Laparoscopic repair of traumatic intraperitoneal bladder rupture

Intraperitoneal rupture of the bladder is an uncommon condition that is usually caused by pelvic fractures. This is a true surgical emergency managed conventionally by open laparotomy with single or double layer repair. We present a case of successful laparoscopic repair of an intraperitoneal bladder rupture secondary to blunt abdominal trauma and pelvic fracture in a 37 year-old man. The repair was done using single layer repair, with successful results

Port site herniation of the small bowel following laparoscopic-myomectomy: a case report

Bowel herniation, through fascial defects secondary to laparoscopic surgery at the site of trocar entry, is a rare, but potentially serious, complication. Closure of the fascia at port sites measuring 10mm or more has been highly recommended to avoid such complications. We report a case of a small bowel which herniated and strangulated through the port site immediately after laparoscopic myomectomy. Resection of the strangulated bowel with primary anastomosis was required to manage this complication. We present this case report with literature review to discuss the risk factors and the methods to prevent such a complication post laparoscopic surgery

Acute cardiovascular emergency: missed killer in the emergency room

Acute chest pain in hypertensive patients presenting to the emergency room constitute a wide spectrum of life threatening conditions including an acute aortic dissection. Acute Aortic syndromes constitute uncommon but lethal identities, with high morbidity and mortality requiring a high index of suspicion, appropriate diagnostic tools and urgent line of management. The authors are reporting a case of an elderly hypertensive lady, presenting with acute chest pain secondary to type B aortic dissection, which was missed on the initial presentation. The authors reviewed the current practice of diagnosing and managing acute aortic dissection