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An abdominal aortic aneurysm (AAA) is a confined dilatation involving the abdominal aorta. The incidence is rare and the etiology is unknown. Cases associated with conditions like Kawasaki, connective tissue, Behcet's diseases, and vasculitis are considered acquired. Our patient had a clinical criterion of Behcet's disease. Management involves a surgical approach. Endovascular intervention is not an option here, as the aneurysm is close to the bifurcation evident in computed tomography angiogram scans. Usually, they have good long-term outcomes. In our paper, we aim to describe the clinical presentation, management approach, and the outcome of our patient with an acquired AAA.
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INTRODUCTION: Slit ventricle syndrome (SVS) is a recognized delayed complication of cerebrospinal fluid (CSF) shunting in children. It had been linked to the use of low-pressure shunts and considered an argument for the use of programmable valves. In this study, we aim to assess the rate of SVS in children that were shunted using fixed-pressure valves. METHODOLOGY: This study is a retrospective cohort study that occurred in King Abdulaziz Medical City, Jeddah, which reviews 100 patients with a median age of 15.5 months that were shunted by using fixed pressure valves during the period from 2010 to 2018. Fixed low-pressure valves were used in 69% of patients, while fixed medium-pressure valves were used in 31% of patients. SVS was defined by the presence of slit-like ventricles (fronto-occipital [F-O] horns ratio was ≤ 0.2 on any post-shunt CT scan) and the occurrence of slit-like ventricle-related symptoms (chronic headache, nausea, vomiting, and altered conscious level_ in the absence of other causes of shunt malfunction. RESULTS: The overall SVS rate in the cohort was 6%. Nine children had slit-like ventricles, but only six of them were symptomatic. Relatively higher SVS rates were observed in younger male children, obstructive hydrocephalus, and medium-pressure valves. Slit-like ventricle-related symptoms in the absence of a slit-like ventricle were reported in 24 out of 91 (26%) patients. A total of 42 patients underwent shunt revisions for other complications. All SVS patients were treated conservatively. There was a temporal fluctuation in the F-O horns ratio and in some patients with SVS their F-O horns ratio returned to normal at further follow-up without intervention. CONCLUSIONS: The overall SVS rate following the use of fixed-pressure CSF valves in children is low and managed conservatively. Not all patients with slit-like ventricles are symptomatic and the radiological appearance of SVS may improve on further follow-up without intervention. Fixed pressure valves remain an acceptable device in the treatment of hydrocephalus in children.
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The occurrence of rhabdomyolysis in pediatric patients is considered a rare complication that can follow certain viral infections in a syndrome better defined as virus-associated rhabdomyolysis. In this research, we will present the case of a ten-year-old male patient who presented to the emergency department with chief complaints of severe bilateral leg pain and inability to walk. Furthermore, the patient complained of dysphagia for both solid and liquid along with dark-colored urine. Initial investigations showed an increase in creatine kinase (CK), C-reactive protein (CRP), and liver enzymes. Additionally, urine analysis was obtained with positive traces of blood, protein, and white blood cell. X-ray was ordered with no significant finding. Finally, the diagnosis was reached in accordance to the results of the respiratory panel multiplex (PCR) as the third case of rhinovirus-induced rhabdomyolysis. He was treated with isotonic intravenous fluids, and he was discharged on hospital day 20 with a CK of 2062 IU/L. The patient was discharged fully recovered, was able to stand and walk alone, and with no complications. In this third to be reported case of rhinovirus-induced rhabdomyolysis, we aim to increase the knowledge among the general pediatric field regarding the possible presentation and treatment of any similar case.
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Colonic atresia (CA) is the rarest type of intestinal atresia and is defined as an obstruction in the large intestinal lumen. This is a rare case presentation of a four-day-old full-term female patient presented with signs and symptoms of intestinal obstruction. Investigation revealed that she had complicated CA located in the splenic flexure. Laparotomy and colostomy were done on the patient. About two months later, she was admitted for stoma closure, which was converted to modified Bishop-Koop stoma. Lastly, the patient underwent a successful stoma closure. Upon one month of follow-up, the patient's condition has markedly improved and the wound healed well without any complications.
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Introduction Colon cancer is the third most common cancer worldwide and its incidence is increasing day by day. Provision of early management to cancer patients can lead to a good prognosis. Hence, we evaluated the risk factors, clinical manifestations and treatment outcomes for colon cancer patients in National Guard Health Affairs (NGHA), Jeddah, Saudi Arabia from January 2010 to December 2020 by comparing those results according to their age groups. Methods A retrospective cohort study was performed on 251 colon cancer patients who underwent a surgical procedure. The patients were divided into the following age groups: ≤ 50 (young), 51-60 and > 60 (old) years old. The demographic variables such as age and gender were collected. The results were classified into risk factors, clinical features and treatment outcomes. The comparison between different age groups was made using Chi-square or Fisher's exact test. The data was stored in Excel 2016 (Microsoft Corporation, Redmond, USA) and analyzed using SPSS (IBM Corp, Armonk, USA). Results The results revealed that most patients were males and the median age for diagnosis was 58 years old. There were 15.1% of patients with a positive family history. Moreover, the most common anatomical position was the left side of the colon in all age groups. Most patients had moderately differentiated colon cancer in the histopathological diagnosis. Laparotomy was the most common procedure done to patients in all age groups. There was no difference between all age groups and the aggressiveness of colon cancer. Young patients (≤ 50 years) had a higher percentage to have 5-year recurrence rate (42 % vs 19% vs 25%, p-value < 0.05) in comparison to patients between 51-60 years and old patients (> 60 years) respectively. However, there was no association between all age groups and 5-year mortality rate (22% vs 9% vs 19%, p-value = 0.171). Conclusion In comparison to old patients (> 60 years), young patients (≤ 50 years) have a more rate of recurrent colon cancer. In relation to all age groups, there were no differences in terms of the aggressive presentation or 5-year mortality rates. In addition, it appears that there were some differences between our study results and worldwide results. This may be because of occupational, cultural and/or genetic variations. Further studies with a higher number of patients and multicenter data collection are highly recommended.
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Pilonidal sinus (PNS) is a clinically diagnosed condition caused by hair entrapment underneath the skin leading to a granulomatous reaction and the formation of a tract. PNS is commonly found in the sacrococcygeal area (natal cleft). However, this is a rare case presentation of a male patient with PNS located at the back of his neck region as there were only four similar conditions reported in the literature review. The patient was first managed medically as a case of hidradenitis suppurativa by the dermatology department. Later on, when the treatment failed, he was treated surgically as a case of PNS with an excellent outcome. The patient was seen at the outpatient clinic one week after surgery. The wound was healed completely and totally recovered.
