ABSTRACT
Thyroid cancer is usually treated with surgical intervention followed by ablative radiotherapy if indicated to eliminate any metastases. Five-year survival rates are 99% for papillary thyroid carcinoma (PTC) and 82% for medullary thyroid carcinoma (MTC). The chances of survival decrease significantly with two simultaneous types of cancers and with male gender. PTC and MTC present as different entities. The coexistence of different types of thyroid carcinoma in a patient is a rare event. We report the case of a 45-year-old Saudi male with a rare synchronous occurrence of PTC in the thyroid gland, along with ectopic MTC with a unique prognosis over the years. Our case adds data to the literature supporting the coincidental coexistence of PTC and MTC.
ABSTRACT
Isolated duodenal transection-a rare complication of abdominal trauma-is a challenging dilemma and difficult to diagnose. As blunt duodenal injuries vary from mild hematoma or perforation to complete transection or complex pancreaticoduodenal disruption. A 21-year-old male medically free victim of motor vehicle collision was admitted to our hospital and evaluated in ER according to ATLS protocol. Patient was stable with positive fast scan so we proceeded for abdomen computed tomography, which showed duodenal injury with possible pancreatic transection and active arterial extravasation. Based on that patient was taken for exploratory laparotomy and primary repair. Duodenal injuries can be a result of different mechanism. Typically, it was the result of crush injury, however, it can be due to shear or bursting forces. With its anatomical location, reaching the accurate diagnosis might be delayed, which is associated with higher mortality rate. Due to different scales of severity and different presentation, the management varies based on the location and the involved surrounding structures. Although complete duodenal transection is rare with blunt injuries, high clinical suspicion is necessary to detect such injury early. Studies have shown that the outcomes are highly dictated by early diagnosis and prompt management.
ABSTRACT
Ganglioneuromas are rare benign neoplasms arising from neural crest tissue. They are a subtype of neurogenic tumors with ganglion cell origin. They are most commonly found in the retroperitoneum and posterior mediastinum. Most ganglioneuromas are found incidentally; most patients are asymptomatic, and it rarely causes symptoms, which are often induced by compression. Here we present a case of a 24-year-old lady, who was investigated for right lower abdominal pain and found to have a right retroperitoneal solid mass at the level of L5-S1, which was displacing the major vessels. The patient underwent open excision of the mass.
ABSTRACT
OBJECTIVES: To investigate the incidence and predictors of traumatic pneumothorax using data from a Level-I trauma center in Riyadh, Saudi Arabia. METHODS: This is a retrospective chart-review study carried out in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Data were extracted from the hospital's trauma registry (2016-2018). A total of 2,109 trauma patients were included. Inclusion criteria were patients ≥16 years old admitted for a traumatic injury. Variables included patient demographics, transport mode, trauma team activation, mechanism of injury, mortality rate, Glasgow Coma Scale and Injury Severity Scores. A logistic regression analysis was constructed to evaluate potential predictors of pneumothorax. Results: Of 2,109 patients included from the trauma registry, 236 (11.2%) were diagnosed with pneumothorax. The majority of the study population was young (19-49 years) (60.7%) and male (79.4%.) Injury mechanism was significantly associated with the presence of pneumothorax (p greater than 0.001). Regression analysis indicated that the odds of having pneumothorax among intentional injury victims was 15 times higher than fall injury victims (OR=15.3, 95% CI= 7.2-32.9). Participants who sustained motor vehicle collision injuries had 3 times higher odds of developing pneumothorax than those who suffered fall injuries (OR=3.1, 95% CI= 1.5-6.1). Conclusion: The incidence of traumatic pneumothorax is sizable and highly associated with the mechanism of injury. Efforts to reduce motor vehicle collision burden should be directly associated with decreasing the burden of traumatic pneumothorax.
