Salah Termos

Laparoscopic management of a small bowel obstruction secondary to Elipse intragastric balloon migration: A case report

Highlights • Elipse™ IGB is a novel procedureless device for weight loss.• We represent a successful laparoscopic management of a small bowel obstruction caused by Elipse™ IGB migration.• This is the first reported adverse event in literature regarding Elipse™ IGB device.

Gallbladder-associated symptomatic hepatic choristoma: Should you resect?

Highlights • The article represents symptomatic hepatic choristoma. To review the literature of this rare entity.• To highlight the awareness of this unexpected finding and familiarity of its possible complications and malignant transformation.• To emphasize that surgical treatment for the symptomatic and suspicious types of ectopic liver tissue mainly located outside the liver.

Giant gastric lipoma presenting as GI bleed: Enucleation or Resection?

Highlights • The article represents giant gastric lipoma with serious GI bleeding. A rare finding of a rare disease that carries significant morbidity and mortality.• To review the literature and to highlight the awareness of this disease and familiarity of its typical radiological findings for reaching proper diagnosis especially in acute setting.• TO emphasize that stomach preserving surgery is an optimal surgical option (enucleation is better than resection).

Ureteropelvic Junction Obstruction and Parathyroid Adenoma: Coincidence or Link?

Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of upper urinary tract obstruction in children. It is generally diagnosed in the routine work-up during antenatal period and is characterized by spontaneous recovery. It can be associated with urolithiasis; hence further investigation should be carried out. We report the case of a 15-year-old boy, who is known to have right UPJO, presented with right renal colic and discovered to have bilateral kidney stones. Further studies showed primary hyperparathyroidism and genetic analysis revealed a CDC73 mutation (initially HRPT2). We believe that association of UPJO and PHPT is a rare coincidence that can be linked. Careful work-up of children with UPJO and urolithiasis is recommended to exclude an underlying metabolic disease. Surgical correction can be evitable as treatment of the primary cause can lead to complete dissolution of kidney stones and improvement of the medical condition.

Rapid and sustained recovery of renal function with transient placement of an intrauretral nephrostomy catheter in an infant with ureteropelvic junction obstruction and acute renal failure.

Ureteropelvic junction obstruction (UPJO) is a common, congenital urinary malformation in the pediatric age group. In most cases the diagnosis is made antenataly and resolves spontaneously. Postnatal diagnosis is made when symptoms of urinary tract infection or abdominal pain occur. We report a six-month-old girl with single kidney and known vesicoureteral reflux grade IV presenting with severe acute renal failure (ARF), requiring acute peritoneal dialysis (PD).After diagnosis of decompensated UPJO, a nephrostomy was performed, and renal function restored within seven days. UPJO was subsequently treated by open pyeloplasty. To our knowledge, this is the first case of UPJO requiring PD due to severe renal failure in a child. Children with UPJO and major morbidity of the contralateral kidney are at risk of renal failure and should therefore be followed carefully to prevent serious complications.

Distinctive vasculopathy with systemic involvement due to levamisole long-term therapy: a case report

BackgroundLevamisole belongs to the antihelminthic class of drugs that are sometimes administered to patients with frequently relapsing or steroid-dependent nephrotic syndrome, owing to its steroid-sparing effects. Neutropenia and skin lesions, compatible with vasculitis, have been reported as drug complications, but they are rarely associated with any systemic involvement.Case presentationWe report a case of a 9-year-old Arab boy with steroid-dependent nephrotic syndrome who was treated with levamisole after his third relapse. The drug was initially well tolerated, but mild isolated neutropenia occurred 6 months after levamisole administration. This was followed by cutaneous vasculitis of both ears and the left cheek. The patient also developed hepatosplenomegaly and anemia. Levamisole was discontinued, and his disease remained in remission. All the systemic manifestations disappeared gradually over the course of 1 month. The patient remained in remission until 1 year after levamisole withdrawal, when clinical nephrosis recurred.ConclusionsDespite levamisole’s being a useful drug for maintaining remission in steroid-dependent nephrotic syndrome, patients on long-term levamisole therapy should be monitored closely to prevent serious complications that can easily be resolved by simple drug withdrawal.

Gall stone ileus: Unfamiliar cause of bowel obstruction. Case report and literature review

Highlights • To highlight a forgotten cause of bowel occlusion due to cholecystoduodenal fistula.• Importance of knowledge of this rare entity and its clinical manifestation.• Familiarity of its radiological findings can lead to early diagnosis and better outcome.• Choice of surgical option must be tailored according to patients medical condition.

Total Gastric Necrosis Due to Mucormycosis: A Rare Case of Gastric Perforation

Patient: Female, 52 Final Diagnosis: Gastric mucormycosis Symptoms: Sepsis • surgical abdomen Medication: Liposomal amphotericine b Clinical Procedure: Total gastrectomy Specialty: Surgery Objective: Rare disease Background: Spontaneous gastric perforation is usually a complication of peptic ulcer disease, or a postoperative complication resulting from gastric torsion. Mucormycosis (or zygomycosis) is an uncommon opportunistic fungal infection that is usually seen in immunocompromised patients and is associated with significant morbidity and mortality. This report is of a rare case of spontaneous gastric perforation due to mucormycosis infection. Case Report: A 52-year-old woman, with a past medical history of heroin abuse, diabetes mellitus, hypertension, and chronic kidney disease treated by dialysis, presented to the emergency department with cellulitis of the arms. Following hospital admission, her medical condition deteriorated, and she developed septic shock and multiorgan failure, requiring transfer to the intensive care unit (ICU), where she was diagnosed with a perforated hollow viscus as the cause. Surgical exploration showed that the mucosa of the stomach was necrotic and perforated, but the remaining bowel appeared normal. Total gastrectomy was performed, and a jejunostomy feeding tube was inserted. Histopathology of the gastric tissue confirmed infection with mucormycosis. The patient was treated with adjunctive liposomal amphotericin B, her condition improved, and she was extubated on postoperative day 2. However, the patient died on postoperative day 21 due to sepsis and multiorgan failure. Conclusions: Mucormycosis is an opportunistic angioinvasive fungal infection, and gastric perforation is a rare clinical presentation. However, knowledge of the association between gastric necrosis and perforation and mucormycosis infection might lead to early diagnosis and treatment and reduce patient morbidity and mortality.

Torsion of huge wandering accessory spleen. Case report and review of literature

Highlights • Wandering accessory spleen of giant sizeis a rare clinical presentation of a common disease that carry significant morbidity and mortality.• To highlight the awareness of the disease and familiarity of its typical radiological findings especially in the acute setting.• To review the literature and describe the different surgical options according to the size and expertise.

Segmental arterial mediolysis with 5 splenic artery aneurysms. A rare finding of a rare disease: Case report and literature review

Highlights • The article represents SAM in SAA which is a rare finding in a rare disease and due to the paucity of sample of cases there is no standardization in the management.• SAM should be suspected when multiple aneurysms are found in the same anatomic site.• Angiography is important to detect adjacent involvement. CT angiography of brain should be done to rule out distal vascular disease.• Endovascular option is the first choice but sometimes it is not feasible, in this case was excluded due to anatomical and configuration reasons.