Thoraco-abdominal impalement injury with an iron rod: A case report.

INTRODUCTION AND IMPORTANCE: Impalement thoracoabdominal injuries are potentially life-threatening due to the associated bleeding and multiple visceral injuries. They are uncommon and often result in severe surgical complications, requiring prompt treatment and extensive care. CASE PRESENTATION: We present a 45-year-old male patient who fell from a 4.5-meter-high tree and landed on a Schulman iron rod stick, which pierced the patient's right midaxillary line, exiting from his epigastric region and leading to multiple intraabdominal injuries and right pneumothorax. The patient was resuscitated and immediately shifted to the operating theater. The main operative findings were moderate hemoperitoneum, gastric and jejunum perforations, and liver laceration. A right chest tube was inserted, and injuries were repaired with segmental resection, anastomosis, and colostomy procedure with uneventful post-operative recovery. CLINICAL DISCUSSION: Providing efficient and prompt care is crucial for patient survival. This includes securing the airways, providing cardiopulmonary resuscitation, and aggressive shock therapy to stabilize the patient's hemodynamic status. The removal of impaled objects is strongly discouraged outside the operation theater. CONCLUSION: Thoracoabdominal impalement injury is rarely reported in the literature; appropriate resuscitative care, prompt diagnosis, and early surgical intervention may minimize mortality and improve the patient's outcomes.

Cecal duplication cyst presenting with acute abdomen: a case report.

Cecal duplication cyst is a rare congenital malformation with a few reported adult cases. We present a 23-year-old man who presented with low-grade fever, constipation, and right lower quadrant pain for three days. An abdominal computed tomography scan showed a cystic mass of 8.8x7.5x6 cm adjoining to the posterior wall of the cecum. The patient underwent abdominal laparotomy, and a right hemicolectomy was performed with resection of the duplication cyst. The histopathological study confirmed the diagnosis of a non-communicating cecal duplication cyst. In conclusion, it is essential to include cecal duplication cyst in the differential diagnosis of the acute abdomen to guarantee the best treatment strategy.

Early Postoperative Complications of Gastrointestinal Surgery and Its Associated Factors in Yemeni Patients Treated in a Teaching Hospital: A Retrospective Monocentric Study.

Background Postoperative complications (POCs) are significant concerns to surgeons because of their possible fatality or long-term disabilities. This study aimed to investigate the early POCs of gastrointestinal surgery and its associated factors in Yemeni patients treated in a teaching hospital in Sana'a University referral hospital. Method A retrospective cross-sectional study from June 2016 to June 2020 was conducted at Al-Kuwait Teaching Hospital, Sana'a University, Yemen. The patients' characteristics, causative factors, primary treatment, and POCs were recorded from their medical profiles. Univariate analysis was utilized to identify the risk factors associated with gastrointestinal POCs within 30 postoperative days. Results The 30-postoperative day mortality was 3.6%, and major POCs occurred in 22 (20%) patients. There is no statistically significant relationship between POCs and age, sex, smoking, khat chewing, comorbidities (diabetes mellitus, anemia, jaundice, heart disease), emergency cases, drain insertion, and operative time (p ˃ 0.05). There was a significant relationship between POCs and preoperative poor nutritional status, high American Society of Anesthesiologists (ASA) grade, need for blood transfusion, major abdominal surgeries, iatrogenic injury, small bowel resection, reoperation, and history of the previous laparotomy (p ≤ 0.05). Conclusion There is a significant relationship between preoperative poor nutritional status, high ASA, need for blood transfusion, major abdominal surgeries, reoperation, small bowel resection, iatrogenic injury, previous laparotomy, and POCs across different gastrointestinal procedures. These factors should be assessed when auditing surgical outcomes.

Morgagni hernia presented as sudden dyspnea in 70 years old man: a case report.

Diaphragmatic hernia is a structural defect caused by inadequate fusion of the pleuroperitoneal membrane of the diaphragm, allowing peritoneal viscera to protrude into the pleural cavity. The occurrence of Morgagni hernia in the adult is infrequent and almost asymptomatic. Symptomatic cases are even rarer, with a wide range of respiratory and gastrointestinal manifestations that make it difficult to diagnose. We present the case of a 70-year-old man with unexpected onset abdominal pain and respiratory distress. The chest computed tomography scan showed the right-side diaphragmatic Morgagni hernia. The defect was corrected through open surgical repair without complications. Within five months of the procedure, a follow-up radiograph revealed full recovery. This case should alert physicians to consider this diagnosis when faced with an unexpected manifestation of Morgagni hernia.