Atypical Unilateral Sacroiliitis Secondary to Mechanical Stress Injury.

We report for the first time a case of atypical unilateral sacroiliitis secondary to mechanical stress injury. Unilateral sacroiliitis can be caused by a variety of etiologies. The first diagnosis to rule out is infection since it requires urgent treatment to avoid its serious consequences. Spondyloarthritis can be manifested by unilateral sacroiliitis in its early stage. Sacral fractures should always be looked for on the imaging modalities performed. In our case, no signs of infection or systemic disease were found. No fracture was seen on the imaging examinations and we had negative cultures on the computed tomography-guided biopsy realized. A history of mechanical stress was the only clue found suggesting the diagnosis of a probable stress related sacroiliitis. A thorough review of the literature will be provided stating the different causes of sacroiliitis described till now, with discussion of this new reported entity.

A late unusual complication after an open cholecystectomy: Amputation neuroma of the CBD causing obstructive jaundice.

INTRODUCTION: Cholecystectomy is one of the most frequently done procedures in general surgery. There are few reports of amputation neuromas following this procedure. This presentation describes a case of obstructive jaundice due to amputation neuroma in a patient with a history of cholecystectomy. CASE PRESENTATION: We report about a 53 y o lady who presented with obstructive jaundice, 8 years following open cholecystectomy. Paraclinical investigations were in favor of cholangicarcinoma, however the final pathology revealed an amputation neuroma of the CBD. DISCUSSION: Amputation neuromas are rarely seen in the era of laparoscopic cholecystectomy. They are benign reparative lesions of the CBD following surgery or manipulation of the extra hepatic biliary tree. It is very difficult to diagnose them pre-operatively. Surgical resection is the first choice of treatment. CONCLUSION: Traumatic neuromas should always be among the differential diagnosis, when assessing a CBD mass in patients with a previous history of open cholecystectomy or surgery to the gastrointestinal tract.

Relation between androgens and cardiovascular risk factors in a young population.

OBJECTIVE: The relationship between androgens and blood pressure, insulin resistance, lipid profile, adiponectin and hs-CRP in a young Middle-Eastern population has not been examined previously. We studied this relationship in a randomly selected population of Lebanese students. METHODS: Three hundred and sixty-eight subjects (201 men and 167 women) aged 18-30 years were included in the study. Anthropometric and biological parameters [waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), triglycerides, total cholesterol, HDL cholesterol, homeostasis model assessment of insulin resistance (HOMA-IR), total testosterone (TT), dehydroepiandrostenedione sulphate (DHEAS), sex hormone-binding globulin (SHBG), adiponectin (ADP) and hs-CRP] were measured. RESULTS: In men, there were inverse associations of both TT and SHBG with body mass index (BMI), WC, HOMA-IR, triglycerides and hs-CRP. After adjustment for major confounders (BMI, WC, age and smoking), associations disappeared except for those between TT and hs-CRP, and for SHBG HOMA-IR, hs-CRP and triglycerides. In women, only SHBG was inversely associated with BMI, WC, HOMA-IR and hs-CRP and positively correlated with adiponectin. Except for the association between SHBG and adiponectin, these correlations disappeared after adjustment for confounders. Although DHEAS appeared to correlate negatively with blood pressure in men, this relationship disappeared after adjustment for confounders, while a relationship between DHEAS and triglycerides in women persisted after such adjustment. In multivariate regression analysis, SHBG was an independent predictor of hs-CRP, triglycerides and HOMA-IR in men and of adiponectin in women. CONCLUSION: Our results suggest that SHBG is independently associated with HOMA-IR, adiponectin, hs-CRP and triglycerides. A gender difference in these associations is observed. Further studies are needed to elucidate these findings.