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Shashaa MN, Alkarrash MS, Alhasan Y, Kabbany SA, Rezkallah V, Alhamr A, Al-Araje MM. A shocking intraoperatively diagnosis of ochronotic knee arthropathy: a case report. Ann Med Surg (Lond) 2024; 86:3009-3012. [PMID: 38694340 PMCID: PMC11060223 DOI: 10.1097/ms9.0000000000001775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/19/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Alkaptonuria is an autosomal extremely rare recessive metabolic disorder with incidence reported to occur as 1:100 000-1:250 000 live births worldwide. This rare metabolic disorder is characterized by the accumulation of homogentisic acid due to a deficiency in homogentisic acid 1,2 dioxygenase. Homogentisic acid subsequently oxidizes and accumulates in the connective tissue. The knee is the most significant peripheral joint to be affected by the disorder. The authors present the first case of ochronotic arthropathy in Syria. Case presentation A 46-year-old male presented with bilateral pain in the knees. the pain was affecting his day-to-day activities, and not responding to conservative management. Anteroposterior standing radiographs demonstrated extensive degenerative disease. Intraoperatively, the diagnosis was done after noticing that the quadriceps tendon and the articular cartilage of the femur, tibia, and patella were blackened during cemented total knee replacement of the knee. Conclusion Ochronotic arthropathy should be kept in mind in middle age patients with severe osteoarthritis to not be surprised by the rare alkaptonuria diagnosis if arthroplasty was indicated.
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Affiliation(s)
| | | | | | | | | | - Alaa Alhamr
- Departments ofOrthopedic and Traumatic Surgery
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Alkarrash MS, Shashaa MN, Kitaz MN, Rhayim R, Ismail M, Swed S, Hafez W, Kaadan MI, Koumakli H, Alhisah N, Al-Haider A, Al-Salloum S, Cherrez-Ojeda I. Basic life support awareness among medical undergraduate students in Syria, Iraq, and Jordan: a multicenter cross-sectional study. Int J Emerg Med 2023; 16:44. [PMID: 37482609 PMCID: PMC10364399 DOI: 10.1186/s12245-023-00521-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/17/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND AND AIMS Basic life support (BLS) training rates vary widely worldwide, and there is a general scarcity of surveys that assess students' knowledge and awareness of BLS in middle eastern nations. This study aims to evaluate medical students' knowledge and awareness towards basic life support. METHODS A cross-sectional study, using an online web-based questionnaire, assessing BLS awareness and knowledge, was conducted from 3 to 30 November 2021. The study included 2114 medical students from Syria, Iraq, and Jordan. The questionnaire consisted of three sections: demographic baseline characteristics, knowledge about BLS, and ability to apply basic life support. A binominal logistic regression was done between the total score and other demographic characteristics to determine if we could predict the research sample's appropriate knowledge of BLS level. RESULTS There was a moderate knowledge of BLS and cardiopulmonary resuscitation (CPR) skills among participating students with an average score of 19.67 (0-34). Seventy-eight of the participants (1656) stated that they have not attended a basic life support course. There was a significant difference between the participants from different countries, where the mean score in Syria, Jordan, and Iraq was 18.3, 24.3, and 18.8, respectively (p < 0.05). Considering the level of knowledge, 18.3%, 72.8%, and 8.9% of the participants had a high, intermediate, and low level, respectively. Furthermore, students who took a BLS course had a higher level of knowledge than those who did not, with an odds ratio of 5.168 (p value < 0.0001). CONCLUSION The overall knowledge of medical students' basic life support knowledge is insufficient and need to be greatly improved. According to this study, previous participation in basic life support training had a positive effect on knowledge level. As a result, universities must establish basic life support programs as quickly as possible.
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Affiliation(s)
| | | | | | - Roaa Rhayim
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | - Sarya Swed
- Faculty of Medicine, University of Aleppo, Aleppo, Syria.
| | - Wael Hafez
- Department of Internal Medicine, Medical Research Division, The National Research Centre, Cairo, Egypt
- NMC Royal Hospital, 16Th Street, Khalifa City, Abu Dhabi, UAE
| | - M Ihsan Kaadan
- Department of Medicine, Boston Medical Center, Boston, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | | | - Nour Alhisah
- Faculty of Medicine, University of October 6 University, Madaba, Jordan
| | - Ahmed Al-Haider
- Faculty of Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq
| | | | - Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab Research Group, Guayaquil, Ecuador
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Alkarrash MS, Shashaa MN, Rhayim R, Aljarad Z. Misdiagnosis of sphincter of Oddi disorder treated as familial Mediterranean fever for ten years: A case report. Ann Med Surg (Lond) 2022; 74:103295. [PMID: 35145669 PMCID: PMC8802060 DOI: 10.1016/j.amsu.2022.103295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/07/2022] [Accepted: 01/23/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Sphincter of Oddi dysfunction is a rare disease caused by sphincter of Oddi functional or mechanical abnormality. Misdiagnosis of familial Mediterranean fever is very high due to overlapping symptoms with many diseases. Our case is the first case report in the medical literature which describes the misdiagnosis of Sphincter of Oddi dysfunction as familial Mediterranean fever. Case presentation A 46-year-old woman presented with recurrent episodes of abdominal pain and arthralgia. The patient had familial Mediterranean fever for ten years which was diagnosed clinically without performing genetic tests. Analysis of the mutation in the MEFV gene was performed and was negative. Thereby, the diagnosis of familial Mediterranean fever was eliminated and colchisine was discontinued. Afterward, laboratory and radiological tests were performed, and the diagnosis of sphincter of Oddi disfunction was confirmed. The patient underwent biliary sphincterotomy and take sulpiride daily. Discussion The most common diseases were misdiagnosed with familial Mediterranean fever are appendicitis, acute rheumatic fever, gastrointestinal diseases and inflammatory arthritis. Endoscopic retrograde cholangiopancreatography with Manometry of the Sphincter of Oddi is the gold-standard test. Conclusion Sphincter of Oddi dysfunction may interfere with many other disorders and should be considered as a differential diagnosis for any recurrent abdominal pain. Misdiagnosis of familial Mediterranean fever is common in endemic countries due to the reliance on clinical symptoms without analysis of the mutations in the MEFV genes particularly, before 1997. SOD should be considered as a differential diagnosis for any recurrent abdominal pain. Misdiagnosis of familial Mediterranean fever is common in endemic countries. ERCP with Manometry of the Sphincter of Oddi is the gold-standard test.
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Brimo Alsaman MZ, Shashaa MN, Alkarrash MS, Kitaz MN, Zazo A, Alhamid A, Zazo R, Haj Kadour S. Normal values of antistreptolysin O for adults ages 30 to 70 in Syria: A cross sectional study. Ann Med Surg (Lond) 2021; 71:103015. [PMID: 34840763 PMCID: PMC8606831 DOI: 10.1016/j.amsu.2021.103015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/23/2021] [Accepted: 10/31/2021] [Indexed: 11/17/2022] Open
Abstract
Background Group A Streptococcus is a very common pathogen which infects a large scale of people around the world causing many symptoms such as scarlet fever, sinusitis, and pneumonia. Most strains of group A and many other strains of group C and G Streptococcus bacteria secreted antigen called Streptolysin O. Anti-streptolysin O (ASO) is an antibody produced against streptolysin O that rises after 1 week of infection by streptococcus bacteria, which helps in diagnosing this type of infectious diseases. We conducted a Cross-Sectional study to determine the Upper Limit of Normal (ULN) for healthy adult in Aleppo, Syria. Materials and methods A sero-epidemiological cross-sectional study was conducted from September to October in 2019. ASO titers were determined on 267 healthy patients’ companions who visited Aleppo University Hospital. Geometric mean titer and Upper Limit of Normal of ASO were calculated according to sex, age and residency. Upper Limit of Normal were defined as the 80th percentile. Results Out of 267 participants; 126 (45.7%) were males and 150 (54.3) were females. The Upper Limit of Normal for total participants was 210.8 IU/ml. There was no significant difference (P-value > 0.05) among males (204.6 IU/ml) and females (225.8 IU/ml). In contrast to sex, there was a significant difference (P-value < 0.05) according to age groups, where the highest Upper Limit of Normal was in the 30–39 age group (256.0 IU/ml). Conclusion ASO test is a common, easy, cheap method, so getting enough data about it is very important in the developing countries (such as Syria). In Aleppo, Syria we found that the ULN was higher than ULN from other studies. There was no significant difference according to sex and residency. On the other hand, there was significant difference according to age groups. The Upper Limit of Normal for total participants was 210.8 IU/ml. We found that the ULN was higher than ULN from other studies. There was significant difference in ULN according to age groups.
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Affiliation(s)
| | | | | | | | - Aya Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Ahmad Alhamid
- MD. Pathology Department, Aleppo University Hospital, Aleppo, Syria
| | - Rama Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Samer Haj Kadour
- Department of Laboratory, Aleppo University Hospital, Aleppo, Syria
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Alkarrash MS, Shashaa MN, Kitaz MN, Rhayim R, Alhasan MM, Alassadi M, Aldakhil A, Alkhamis M, Ajam M, Douba M, Banjah B, Ismail A, Zazo A, Zazo R, Abdulwahab M, Alkhamis A, Arab A, Alameen MH, Farfouti MT. Migraine and tension-type headache among undergraduate medical, dental and pharmaceutical students of University of Aleppo: a cross-sectional study. BMJ Neurol Open 2021; 3:e000211. [PMID: 34712954 PMCID: PMC8515458 DOI: 10.1136/bmjno-2021-000211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/29/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction Headache disorders are among the most common 10 causes of disability worldwide according to the global burden of disease survey 2010. Headache is also wildly common among universities students when compared with other populations. The purpose of this study is to assess headache prevalence among Aleppo University medical, dental and pharmaceutical undergraduate students. Methods A questionnaire-based cross-sectional study was conducted among medical, dental and pharmaceutical students at Aleppo University, Syria. We determined the type of headache according to the International Classification of Headache Disorder-III. The total number of participants was 2068. A χ2 test was used to evaluate the association between the categorical outcomes. P<0.05 was considered significant. Results Out of 2068 participants, 1604 (77.6%) were medical students, 205 (9.9%) were dental students and 259 (12.5%) were pharmaceutical students. The effect on daily activities was higher in chronic tension headache (96.7%) and migraine without aura (94.6%) than migraine with aura (91.3) and episodic tension headache (85.1%). Out of 1191 who had a headache, only 188 (15.9%) had a medical consultation. Conclusions There was no a statistically significant difference in prevalence of tension headache and migraine according to faculties. There was a statistically significant difference in patients with migraine according to academic year, living with family and smoking. The effect on daily activities was higher in chronic tension-type headache and migraine without aura. There is a significant lack of medical consultation among students and most of them took over the counter analgesics depending on personal choice.
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Affiliation(s)
| | | | | | - Roaa Rhayim
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | | | - Maya Alassadi
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Ahmad Aldakhil
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Mohamad Alkhamis
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Mohanad Ajam
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Mohamad Douba
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Bashar Banjah
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Ahmad Ismail
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Aya Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Rama Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Majd Abdulwahab
- Faculty of Pharmacy, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Ali Alkhamis
- Faculty of Pharmacy, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Abdullah Arab
- Faculty of Dentistry, University of Aleppo, Aleppo, Syrian Arab Republic
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Alkarrash MS, Badawi R, Sallah H, Shashaa MN, Argilo J, Alkhoury R. Hemophilia A and C in a female: The first case report in literature. Ann Med Surg (Lond) 2021; 68:102561. [PMID: 34336195 PMCID: PMC8318996 DOI: 10.1016/j.amsu.2021.102561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION One of the relatively rare hemostatic disorders is coagulation factors' deficiency, where a single factor or multiple factors can be deficient. All hereditary coagulation factors' deficiencies are autosomal recessive, so they can manifest in both genders, but Hemophilia A and B are X-linked disorders. Therefore, females can rarely be affected. This paper reports the first case of simultaneous coagulation factors' deficiencies of FVIII and FXI in a female. CASE PRESENTATION A 17-year-old female came to the office due to prolonged epistaxis, with a history of severe menstrual bleeding and frequent episodes of epistaxis. In her familial history, a brother complained of epistaxis episodes. Bleeding time and prothrombin time were normal but activated partial thromboplastin time was increased. Von Willebrand disease was excluded, and she was diagnosed with hemophilia A and C. DISCUSSION Females can be affected with X-linked disorders such as hemophilia A and B in some rare cases: a carrier mother and affected father, skewed X chromosome inactivation, Turner syndrome, inhibiting antibodies (acquired hemophilia), or a sporadic mutation on the most activated X chromosome. On the other hand, Hemophilia C is an autosomal recessive disease. Treatment of such cases is a challenge, and the recombinant coagulation factors are the treat-of-choice. CONCLUSION Although Von Willebrand disease is the most common hereditary bleeding disorder in females, other rare diseases could be suspected such as Hemophilia. X-linked Hemophilia should be kept in mind as a differential diagnosis in any female patient suffering from hemorrhage.
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Key Words
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- Coagulation factor deficiencies
- ECG, electrocardiogram
- ESR, Erythrocyte sedimentation rate
- FMCFDs, familial multiple coagulation factor deficiencies
- FVII, factor VII
- FVIII, factor VIII
- FXI, factor XI
- Factor VIII
- Factor XI
- Familial multiple coagulation factor deficiencies
- Female
- Hemophilia
- IU, international unit
- PT, prothrombin time
- WBC, white blood cell count
- aPTT, activated partial thromboplastin time
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Affiliation(s)
| | - Rayan Badawi
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Hala Sallah
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | - Jerair Argilo
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Rawad Alkhoury
- Hematology Department, Ibn Rushd Hospital, Aleppo, Syria
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Al-Mousa A, Shashaa MN, Alkarrash MS, Alkhamis M, Ghabreau L, Dandal M. Unusual case of classic testicular seminoma in a 90-year-old patient: a case report. J Med Case Rep 2020; 14:182. [PMID: 33032642 PMCID: PMC7545890 DOI: 10.1186/s13256-020-02517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 08/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seminoma is the most common subtype of testicular cancer and occurs most commonly in patients aged 30-49 years, but decreases to a very low level in men in their 60s or older. CASE PRESENTATION A 90-year-old Syrian man with a 6-year history of an increase in size of his right scrotum, presented to the urological clinic and, on clinical examination, the findings suggested testicular tumor. After orchiectomy and histology results based on microscopic and immunohistochemical examinations, a pure seminoma was diagnosed, so we describe in this case report the second-oldest patient with classical seminoma in the medical literature. CONCLUSION This case report has been written to focus on the probability of any type of testicular tumor occurring at any age or decade; urologists should consider seminoma as a differential diagnosis with any testicular swelling even in elderly patients.
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Affiliation(s)
- Ahmad Al-Mousa
- Department of Urology, Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | | | | | - Lina Ghabreau
- Department of Pathology, Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Mouhsen Dandal
- Department of Urology, Faculty of Medicine, University of Aleppo, Aleppo, Syria
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Zazo A, Zazo R, Shashaa MN, Alkarrash MS, Brimo Alsaman MZ, Niazi A. Uncommon musculoskeletal femoral hydatid cyst disturbs a female for a year: Case report. Ann Med Surg (Lond) 2020; 55:30-32. [PMID: 32435477 PMCID: PMC7231815 DOI: 10.1016/j.amsu.2020.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/10/2020] [Accepted: 04/18/2020] [Indexed: 11/11/2022] Open
Abstract
“Hydatid cyst” which also known as cystic Echinococcosis is a parasitic infestation caused by the larval stage of Echinococcus granulosus. The liver and lungs are the most sites to occur. Incidence in muscles is exceptionally rare. We report a case of a 36-year-old female presented with an uncomfortable mass in the upper medial of her right thigh without any presence of other symptoms. She lived in a rural area in Manbij, which is an endemic area of hydatid cysts in Syria. She was a shepherdess; therefore she had direct contact with sheep and dogs. Ultrasound examination showed a cyst located between adductor longus muscle and gracilis muscle closed to the deep femoral artery. The patient was treated with pharmaceutical therapy for a week before cystectomy, which was done under general anesthesia. The cyst was dissected between the fibers of adductor longus muscle from the lateral side and fibers of the gracilis muscle from the medial side. The cyst with all its layers was resected. Musculoskeletal Echinococcosis is a rare disease, because of intramuscular growth of cysts is restricted by muscle's contractility, the muscles are undesirable habitat for Echinococcus granulosus and because of the hepatic barrier role. Many cysts are revealed by complications such as nerve compressions, infections simulating an acute abscess or a malignant tumor. Hydatid cyst present as mass of soft tissue, particularly in endemic areas, as a result of contaminated water. MRI considered the best technique in the diagnosis. Incidence of Hydatid cyst in muscles is exceptionally rare. MRI considered the best technique in the diagnosis. Confirming the final preoperative diagnosis of muscle hydatid cysts is important. Hydatid cyst should consider as a differential diagnosis for masses of soft tissue.
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Affiliation(s)
- Aya Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Rama Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | | | | | - Ammar Niazi
- General Surgery Department, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria
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Ayoub K, Alkarrash MS, Shashaa MN, Zazo A, Rhayim R, Mahli N. A rare complication of gallstones ended with spontaneous cholecystocutaneus fistula in an old man: A case report. Int J Surg Case Rep 2020; 67:42-44. [PMID: 32004903 PMCID: PMC6994846 DOI: 10.1016/j.ijscr.2020.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/29/2019] [Accepted: 01/08/2020] [Indexed: 01/02/2023] Open
Abstract
Cholecystocutaneous fistula is an extremely rare complication for gallstones. The diagnosis is not easy because symptoms are nonspecific. Computed tomography considers the gold standard in diagnosing this case. First procedure was laparoscopic, but greater omentum adherent to the gallbladder. So we turned to open technique to perform cholecystectomy and resection the fistula.
Introduction Cholecystocutaneous fistula is an extremely rare complication of gallstones. The majority of the fistulae localize into the right upper quadrant of the abdomen. Diagnosis is not easy because the symptoms are nonspecific. External biliary fistula is more common in females between the 5th-7th decades because in this age group the frequency of cholecystitis is increased. Case presentation A 65-year-old man presented with a swelling in the right hypochondrium. He had not complained of any serious symptoms. Laboratory investigations were normal. Both abdominal ultrasound and Multislice computed tomography (MSCT) showed that the gallbladder contained stones, in addition to a cystic mass in the abdominal wall. The previous findings suggested that there was an abscess. So, the patient underwent laparoscopic procedure, and we found a fistula between the gallbladder and the abdominal wall causing the abscess. The greater omentum was adherent to the inflamed gallbladder. So that we transformed into open procedure to perform cholecystectomy and resect the fistula. Discussion Biliary fistulae have two types, external and internal. The most common type is internal. External biliary fistulae emerge like a complication of cholecystolithiasis in general. Spontaneous cholecystocutaneous fistulae occur due to acute inflammation caused by cholecystitis or chronic gallstones disease. The most common clinical manifestation is an abscess in the abdominal wall that discharges bile to the outside. Conclusion Computed tomography is considered the gold standard in diagnosing a spontaneous cholecystocutaneous fistula, and it should be considered as a differential diagnosis for any abscess that is evident in the abdominal wall.
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Affiliation(s)
- Kusay Ayoub
- Surgery Department, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria
| | | | | | - Aya Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syria.
| | - Roaa Rhayim
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Nihad Mahli
- Surgery Department, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria
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Al-Mouakeh A, Shashaa MN, Brimo Alsaman MZ, Zazo A, Alkarrash MS, Zazo R, Niazi A. Trichobezoar in a young girl caused by ingestion of bristles brush for more than a decade: A case report. Int J Surg Case Rep 2019; 61:48-50. [PMID: 31323484 PMCID: PMC6637247 DOI: 10.1016/j.ijscr.2019.05.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/20/2019] [Indexed: 11/25/2022] Open
Abstract
Ingestion of hair and bristle brush led to unique type of trichobezoars. Trichobezoars led to gastric outlet obstruction. The diagnosis is made by abdominal X-ray, computed tomography scan and endoscopic examination. Surgical intervention is performed for the majority of patients.
Introduction Trichobezoar is a rare cause of bowel obstruction. In general, Trichobezoars are composed of hair and usually found incidentally in patients undergoing upper gastrointestinal endoscopy or imaging. Patients diagnosed with Trichobezoar may have psychiatric disorders. Discussion Trichobezoars cause nonspecific symptoms like asymptomatic abdominal mass, vomiting, nausea, and anorexia. Diagnosis of Trichobezoar is made by endoscopic examination and radiological methods. Therapeutic options for trichobeazoar are chemical dissolution, endoscopic removal or surgery. Case presentation Here we present a case of an 18-year-old girl who has a unique type of Trichobezoars caused by ingestion of hair and bristle clothes brush for 14 years. She presented to the surgical clinic complaining of vomiting, anorexia and epigastric mass. Abdominal computed tomography scanner showed nonattached intragastric mass which was consistent with trichobezoar. The patient was managed by surgical removal of the intragastric mass. Conclusion Trichobezoar is caused by chronic ingestion of hair; it is commonly seen in young females who may have psychological disorders, such as trichophagia and trichotillomania. Common symptoms are abdominal pain, nausea, vomiting, and weight loss. Surgical intervention is performed for the majority of the patients.
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Affiliation(s)
| | | | | | - Aya Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | - Rama Zazo
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Ammar Niazi
- Surgery Department, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria
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