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Hajj Experience of General Surgery department in Al-Noor Specialist hospital. Dr.Meshal Al-Harthy, MD Consultant General Surgeon. Dr.Mohammad Amin K Mirza Saudi Board of Surgery. April 2008. Case 1. 54 y.o Turkish, male

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hajj experience of general surgery department in al noor specialist hospital

Hajj Experience of General Surgery department in Al-Noor Specialist hospital

Dr.Meshal Al-Harthy, MD

Consultant General Surgeon

Dr.Mohammad Amin K Mirza

Saudi Board of Surgery

April 2008

case 1
Case 1
  • 54 y.o
  • Turkish, male
  • Sudden abdominal pain , at the umbilical area, for 4 hrs , severe in nature
  • Pt is in severe distress, tachepnic, & hypotensive
  • Abdomen:Skin is dusky. Soft lax , mild tenderness in umbilical region.
slide4

CXR: no free air

  • AXR: Dilated large bowel localized at Rt side.

No leucocytosis

slide10

Whole small bowel gangrene?

  • Whole large bowel gangrene?
  • Part of small bowel & colon?
  • Ischemia of intestine &multiple small Gangrenous patches throughout the jejunum?
risk factors of mesenteric vascular occlusion
Risk factors of mesenteric vascular occlusion
  • Atrial fibrillation
  • Low circulatory state( CHF, Shock)
  • Dehydration
  • Excessive exercise
  • Protein S defficiency
case 2
Case 2
  • 23 y Saudi , male Pt
  • Sudden onset of sever abdominal pain & constipation
  • Generally stable, but in sever pain
  • Abdomen is distended , tender all over ,, with guarding
volvulus
volvulus
  • More common in men, occurringin 63.7% of men.
  • The average age at which sigmoid volvulus occurs in English-speaking countries is 60 to 65 years, although it tends to occur 15 to 20 years earlier in other parts of the world.
  • Black > White
  • Types:
  • Caecal
  • Transverse colon
  • Sigmoid
sigmoid decompression and colopexy
Sigmoid Decompression and Colopexy

Salim AS. Management of acute volvulus of the sigmoid colon: a new approach

by percutaneous deflation and colopexy. World J Surg 1991; 15:68–73.

slide29
T-Fasteners Sigmoidopexy

Gallagher et al.

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