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  • 1.
    Abdelaal, Abdelrahman
    et al.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Abusabeib, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Farghaly, Hanan
    Department of Lab Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
    Tabeb, Abdelhakem A. M.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Simultaneous occurrence of follicular and papillary thyroid carcinomas in same thyroid lobe: A case series of six patients from Qatar2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 73, s. 65-70Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) are the first and second most common thyroid cancers comprising about 85% and 10% of all thyroid cancers. Simultaneous occurrence of medullary and papillary thyroid cancer has been reported with various presentations, but simultaneous occurrence of FTC in addition to PTC as differentiated cancers, is an unusual event that is rarely reported. Presentation of cases: We report our experience of six rare cases of synchronous coexistence of FTC and PTC with unique features. Case 1 is 31 old Egyptian female. Case 2 is a 61 year old Sudanese male. Case 3 is a 59 year old Sudanese male. Case 4 is a 56 years old Indian female. Case 5 is a 35 years old Filipina female. Case 6 is a 52 years old Qatari female. The six cases are special in their co-occurrence of two thyroid carcinoma, consisting of histologic features of follicular thyroid carcinomas, and classical papillary thyroid carcinoma, possibly the first case series of simultaneous occurrence of these two types of thyroid cancer in the Middle East and North Africa Region. Conclusions: We present rare cases of concurrent FTC and PTC. These six cases add more data highlighting the coincidental simultaneous coexistence of FTC and PTC. Endocrinologists and pathologists should be aware of and vigilant to this variety. © 2020 The Author(s)

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  • 2.
    Abusabeib, Abdelrahman
    et al.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Bhat, Harun
    Weill Cornell Medicine in Qatar, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Al Hassan, Mohamed S.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Right ectopic paraesophageal parathyroid adenoma with refractory hypercalcemia in pregnancy: A case report and review of the literature2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 77, s. 229-234Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Introduction: Ectopic parathyroid adenoma is rare during pregnancy but poses multiple challenges in treatment. It presents as primary hyperparathyroidism which leads to symptoms and complications of hypercalcemia in both the mother and fetus. Presentation of case: A 38-year-old Sudanese female presented with diffuse bone pain and polyuria. Laboratory investigations revealed elevated serum calcium and parathyroid hormone. Ultrasound of the neck did not show any abnormal lesion, however 99mTc-sestamibi scan showed a right sided parathyroid adenoma, and an earlier CT scan showed the adenoma to be in an ectopic paraesophageal position. Focused surgical neck exploration was done, and the ectopic parathyroid adenoma was excised. Discussion: Preoperative localization of the ectopic parathyroid adenoma allows for a focused surgical procedure. Ultrasound is the safest during pregnancy, but 99mTc-sestamibi and CT scan may be necessary if ultrasound or initial bilateral neck exploration do not detect any adenoma. Mild elevations in maternal serum calcium can have detrimental effects on the fetus which suggests that a surgical approach may be necessary in the majority of cases. Conclusions: Ectopic parathyroid adenoma is rare during pregnancy and is detrimental to both the mother and fetus. Preoperative localization allows for a focused surgery which is a definitive treatment and can safely be performed during the 2nd trimester of pregnancy. 

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  • 3.
    Abusabeib, Abdelrahman
    et al.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar.
    Al Hassan, Mohamed S.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Petkar, Mahir
    Department of Laboratory Medicine & Pathology, Hamad Medical Corporation, Doha, Qatar.
    Mohamed, Sugad
    Department of Laboratory Medicine & Pathology, Hamad Medical Corporation, Doha, Qatar.
    First case of huge classic papillary thyroid cancer rupturing spontaneously leading to ischemic necrosis, perforation and inflammation of overlying skin: Case report and review of the literature2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 85, artikel-id 106136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Papillary thyroid cancer (PTC) is the commonest form of well-differentiated endocrine carcinoma. It is categorized into indolent and aggressive, where the indolent subtypes (classic, follicular) rarely demonstrate aggressive behavior. We present a classic PTC presenting with a rapidly growing huge anterior neck mass that subsequently spontaneously ruptured subcutaneously resulting in ischemia, necrosis, and perforation of overlying skin leading to inflammation. Presentation of case: A 37-year-old female with no comorbidities presented to our emergency department with a neck swelling of 2 years duration that rapidly enlarged one week prior to presentation. Though the mass initially appeared of inflammatory nature, the tumor was a PTC, and she underwent total thyroidectomy with selective right side neck dissection and debridement of necrotic skin. The gross specimen revealed a fragmented non-intact right thyroid lobe mass causing pressure ischemia, necrosis and perforation of the skin. Histopathology showed a 9 × 9 × 5 cm classic PTC staged as pT3b N1b. Postoperative course was uneventful, she was discharged by the eighth postoperative day, and then she received a high dose of radioactive iodine ablation (RAI). Discussion: Classic PTC is usually of a smaller size and a relatively benign course compared to other PTC subtypes and thyroid cancers. It is indolent with favorable prognosis. Although it is associated with increased risk of lymph node metastases at the time of diagnosis, it is slow growing with high survival rates approaching 95%. Conclusion: Despite that classic PTC progresses slowly, it should still be suspected in neck swellings presenting with rapid and aggressive behavior. Prompt and systematic assessment is required with surgical intervention and radioactive iodine ablation therapy. 

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  • 4.
    Ahlsson, Anders
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
    Friberg, Örjan
    Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Källman, Jan
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    An angry cat causing Pasteurella multocida endocarditis and aortic valve replacement: A case report2016Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 24, s. 91-93Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Cat bite infections usually involve a mix of anaerobic and aerobic bacteria including species of Pasteurella, Streptococcus, Staphylococcus, Bacteroides, and Fusobacterium. We report a case of Pasteurella multocida infection from cat bites leading to endocarditis and subsequent aortic valve replacement.

    PRESENTATION OF CASE: A 70-year-old male was admitted because of fever, tachycardia, and malaise. He had a history of alcohol abuse and was living alone with a cat in a rural area. A sepsis of unknown origin was suspected, and intravenous treatment with gentamicin and cefotaxime was initiated. Blood cultures yielded Pasteurella multocida, and the patient history revealed repeated cat bites. After four days, the patient was discharged with oral penicillin V treatment. Two weeks later, the patient returned with fever and a new systolic murmur. An aortic valve endocarditis was diagnosed, and it became clear that the patient had not completed the prescribed penicillin V treatment. The patient underwent a biological aortic valve replacement with debridement of an annular abscess, and the postoperative course was uneventful.

    DISCUSSION: Endocarditis due to Pasteurella is extremely rare, and there are only a few reports in the literature. Predisposing factors in the present case were alcohol abuse and reduced compliance to treatment.

    CONCLUSION: Cat bites are often deep, and in rare circumstances can lead to life-threatening endocarditis. Proper surgical revision, antibiotic treatment, and patient compliance are necessary components in patient care to avoid this complication.

  • 5.
    Aineskog, Helena
    et al.
    Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    A case report of a complete degloving injury of the penile skin2016Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 29, s. 1-3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Male genital degloving injuries are unusual and rarely caused by animal bite. Usually patients attend health care immediately if bitten in the genital area. Prophylactic antibiotics is routinely used (Gomes et al., 2000). A penile degloving usually begins just proximal of the coronal line and progress down to the base of the shaft. Deep erectile tissue and the spermatic cord are seldom damaged and the endogenous skin of glans usually survives (Brown and Fryer, 1957; Morey et al., 2004; Finical and Arnold, 1999).

    PRESENTATION OF CASE: A heavily smoking man with a previous history of bladder cancer presented himself to the emergency department 24h after a dog bite degloved his penis. The avulsed skin was necrotic and subsequently excised. Antibiotic treatment was started. A bacterial swab was found positive for canine oral flora. The skin defect was closed using a 1:1 meshed split thickness skin graft from the inner thigh. Smoking cessation was encouraged. At the three month follow up the patient expressed satisfaction with both cosmetic and functional result and was now non-smoking.

    DISCUSSION: Several approaches to reconstruct penile skin exist. Split thickness skin graft has been lifted as a preferable alternative (Brown and Fryer, 1957; Finical and Arnold, 1999; Paraskevas et al., 2003) [5]. In this case, the avulsed skin was necrotic and could not be used. A 1:1 meshed split-thickness graft was chosen with excellent results.

    CONCLUSION: 1:1mesh of the graft can be recommended for easy attachment with a good functional and esthetical result. The potential risk of losing intimacy appearance or having to go through repeated procedures in the genital area motivated smoking cessation for this patient.

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  • 6.
    Al Dhaheri, Mahmood
    et al.
    Department of Colorectal Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Nada, Mohamed Abu
    Department of Colorectal Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Kurer, Mohamed
    Department of Colorectal Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Ahmed, Ayman Abdelhafiz
    Department of Colorectal Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Left iliac fossa mini-incision sigmoidectomy for treatment of sigmoid volvulus: Case series of six patients from Qatar2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 75, s. 534-538Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Midline laparotomy is the definitive treatment for sigmoid volvulus after initial colonoscopic detorsion. We successfully adopted another technique at our center on 6 patients, treating sigmoid volvulus by left iliac fossa mini-incision. Presentation of cases: We report our experience of six non-consecutive cases of sigmoid volvulus treated by left iliac fossa mini-incision. The cases were a 33 year old Egyptian female, a 21 year old Bangladeshi male, a 58 year old Qatari male, a 30 year old Ethiopian male, a 36 year old Ugandan male, and a 58 year old Indian male. The six cases are unique in the surgical technique employed in their management. This is possibly the second case series of left iliac fossa mini-incision for sigmoid volvulus in the Middle East and North Africa Region. Discussion: All patients underwent initial colonoscopic detorsion followed by sigmoidectomy and anastomosis. The procedure was successful in treating the volvulus in five patients with no complication or recurrence over a mean follow up of 8 months (range: 1–36 months). One patient required further laparotomy and resection with anastomosis due to incompletely removed sigmoid colon. Conclusions: Left iliac fossa mini-incision for sigmoid volvulus is safe, feasible, cosmetically appealing and with low morbidity.

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  • 7.
    Al Hassan, Mohamed S.
    et al.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar ; Weill Cornell Medicine – Qatar, Doha, Qatar.
    Alater, Ahmad
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    Darweesh, Adham
    Department of Clinical Imaging, Hamad General Hospital, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    Choroidal metastasis as initial presentation of aggressive medullary thyroid carcinoma with widespread mediastinal, brain, pituitary, bone, lung, and liver metastasis: Case report and literature review2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 87, nr October 2021, artikel-id 106419Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor that originates from the parafollicular C cells of the thyroid gland. MTC can be due to sporadic or hereditary causes due to gain of function germ line mutations in the RET proto-oncogene. MTC presenting as ocular symptoms due to choroidal mass is rare with bad prognosis. Presentation of case: A 38-year-old Sudanese male presented to Hamad General Hospital, complaining of sudden painless decrease of vision of the right eye of 3 weeks duration. After investigations using imaging methods, the patient was discovered to have metastatic MTC that presented as choroidal mass and metastasized to his lung, bone, brain, pituitary, liver and mediastinum. Discussion: In terms of investigations, serum levels of calcitonin have superior diagnostic accuracy. Our patient undertook diagnostic imaging including ultrasonography, fine needle aspiration and computerized tomography (CT) scan and/or MRI imaging. He undertook total thyroidectomy and left neck dissection followed by stereotactic radiosurgery for the right orbit and pituitary. He then received systemic anti-RET therapy (Selpercatinib). At 5 months follow up there was dramatic drop in CEA from 888 μg/L to 164 μg/L, and calcitonin from >585.2 pmol/L to 354 pmol/L. Conclusion: Choroidal metastasis as initial presentation of MTC is extremely rare and challenging to diagnose. Surgeons need a high index of suspicion when ocular symptoms accompany a neck mass or thyroid-related symptoms. MTC has a progressive course with involvement of blood vessels and neck lymph nodes. Choroidal metastasis of MTC is challenging to manage.

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  • 8.
    Al Hassan, Mohamed S.
    et al.
    Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar ; Weill Cornell Medicine – Qatar, Doha, Qatar.
    El Baba, Hamzah
    Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Petkar, Mahir
    Department of Laboratory Medicine and Pathology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    What you see might not be what you get: Analysis of 15 prospective cases of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)2022Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 91, artikel-id 106751Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Noninvasive follicular thyroid neoplasm with papillary-like nuclear (NIFTP) is a new entity. No previous study reported prospective cases, outlining using many quantitative and qualitative variables. Methods: Retrospective analysis of all (15) prospective NIFTP cases diagnosed between 2017 and 2021 at our institution. Statistical quantitative analysis outlined demographic, history, ultrasound, histopathology and treatment characteristics. Qualitative analysis examined the cases, with details provided on three cases to highlight the different possible presentations and configurations. Results: Mean age was 41.5 ± 9.91 years, 73.3% were females, and mean BMI was 29.49 ± 5.74 kg/m2. About 87% patients were symptomatic; 86.6% had neck swelling. Ultrasound (US) showed multiple nodules in 71.4% of cases. Fine-needle aspiration cytology (FNAC) showed that follicular lesion of undetermined significance (42.8%) was most common, followed by benign nodule (21.3%). Using the Bethesda System for Reporting Thyroid Cytopathology, 7 cases were category III, 3 category IV, 3 category II, and 1 category I. 60% of patients underwent total thyroidectomy. All cases were diagnosed postoperatively, 2 patients had additional papillary microcarcinoma. In 3 cases, the NIFTP site in the histopathology of resected specimen was different than the US-recommended site of the FNAC. Conclusion: We found discrepancies in the site and diagnosis of the preoperative US recommendation for the FNAC vs the postoperative histopathology of the specimen. These suggest that NIFTP might be incidentally and postoperatively diagnosed, irrespective of US or FNAC findings, hence its ‘true’ incidence might remain underestimated. As NIFTP cases higher BMI, Future research could predict preoperative diagnosis of NIFTP and explore associations with BMI. 

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  • 9.
    Al Hassan, Mohamed S.
    et al.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Elshafeey, Abdallah
    Weill Cornell Medicine – Qatar, Doha, Qatar.
    Petkar, Mahir
    Department of Laboratory Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    First bilateral non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) co-occurring with bilateral papillary thyroid microcarcinoma: Case report and literature review2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 78, s. 411-416Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Non-invasive follicular thyroid neoplasm with papillary-like features (NIFTP) is a recently characterized lesion with very low malignant potential. This has allowed for less aggressive management of this tumor subtype. Papillary thyroid carcinoma (PTC) has malignant potential and requires different considerations in management. Presentation of case: A 33-year-old woman presented to our Thyroid Surgery Clinic with a left neck swelling slowly enlarging over 4 years, and recent right-sided neck pain. Neck ultrasound and fine needle aspiration for cytology found bilateral thyroid nodules, labelled as ‘follicular lesion of undetermined significance’ (FLUS). Final pathology report after total thyroidectomy identified four distinct tumors: bilateral NIFTP lesions and bilateral papillary microcarcinomas. Discussion: Management of NIFTP comprises partial or total thyroidectomy without further intervention. Management of PTC is the same but with the possible addition of radioactive ablation due to the increased malignant potential. This is the first report of bilateral NIFTP lesions and bilateral papillary microcarcinomas co-occurring together in the same patient, so management was challenging. The decision was made to give the patient low dose radioactive iodine ablation and continue monitoring. Ultrasound of the neck follow up 6 months later showed no residual thyroid tissue or local recurrence. Conclusion: Although rare, NIFTP can co-occur with PTC. Bilateral NIFTP with bilateral PTC is extremely rare. Surgeons and pathologists need to be aware of this rare entity that can co-occur in both thyroid lobes. Total thyroidectomy is the definitive treatment. Post-surgery surveillance is important and follow up needs to be watchful for any recurrence or metastasis. © 2020 The Author(s)

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  • 10.
    Al Zoubi, Mohammad
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Al Moudaris, Ahmed A.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Largest case series of giant gallstones ever reported, and review of the literature2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 72, s. 454-459Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Giant/large gallstones have high risk of complications, and technical difficulties during surgery. This case series is the largest ever reported. Presentation of cases: Case 1: Female (44 years), with one year intermittent right upper quadrant colicky pain. Ultrasound: large gallstone (normal gallbladder). Elective laparoscopic cholecystectomy (LC): 6 × 4 × 3.3 cm gallstone. Case 2: Female (41 years), presented to emergency room with 3 days right upper quadrant pain/tenderness, vomiting, and positive murphy's sign. Ultrasound: large gallstone, calculus cholecystitis. Emergency LC: 4.5 × 3.1 × 3.5 cm gallstone. Case 3: Male (38 years), with history of gallstones and acute cholecystitis presented with intermittent right upper quadrant pain (2 months) and vomiting. Normal abdominal examination. Ultrasound: large gallstone. Elective LC: 4.1 × 4 × 3.6 cm gallstone. Conclusions: Gallstones >5 cm are very rare, with higher risk of complications. Gallbladder should be removed even if asymptomatic. Gallstones >3 cm have increased risk for gallbladder cancer, biliary enteric fistula and ileus. LC has challenges that include grasping the gallbladder wall, exposure of Calot's triangle, and retrieval of gallbladder out of the abdomen. LC appears to be procedure of choice and should be performed by an experienced surgeon, considering the possibility of conversion to open cholecystectomy in case of inability to expose the anatomy or intraoperative difficulties. © 2020 The Author(s)

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  • 11.
    Aleter, Ammar
    et al.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Incidental appendiceal mucinous neoplasm mimicking a left adnexal mass: A case report2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 74, s. 132-135Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Appendiceal mucinous neoplasm is a rare type of appendiceal tumors which can present in a variety of symptoms and is difficult to diagnose. Preoperative diagnosis depends mainly on diagnostic imaging such as ultrasonography and computerized tomography (CT) scan. This uncommon case report discusses an appendiceal mucinous neoplasm mimicking a left adnexal mass on presentation, physical examination and diagnostic imaging findings. Presentation of case: This is a 61-year-old female found to have a large left adnexal mass during follow up ultrasonography. The patient refused further imaging, and during laparotomy, she was found to have an appendicular mucocele with normal left and right ovaries. Discussion: Appendectomy was done and the final pathology came as appendiceal mucinous neoplasm. Her post-operative course and 3 years follow up were uneventful. Conclusions: The equivocal signs and symptoms along with the anatomical position of appendiceal mucocele makes it difficult to diagnose and can mimic other types of tumors. Therefore, it should be considered in the deferential diagnosis of lower abdominal and pelvic masses. 

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  • 12.
    Alhardallo, Mutaz
    et al.
    Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar.
    Baco, Abdul M.
    Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Second ever reported case of central cause of unilateral foot drop due to cervical disc herniation: Case report and review of literature2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 83, artikel-id 105928Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Foot drop is defined as a weakness in the ankle and foot dorsiflexors. A disruption of the neural pathway starting from the motor prefrontal cortex and ending in the peroneal nerve can lead to foot drop. Foot drop due to lower motor neuron injury is well documented. However, foot drop due to a central cause of cervical disc prolapse is very rare. Case presentation: A 55-year-old male presenting with neck pain, right and left arms radicular pain and numbness, and unilateral right foot drop following cervical disc prolapse. The patient presented with upper motor neuron lesion signs. MRI showed cervical disc prolapse at two levels, confirming central cause of foot drop. The patient underwent anterior cervical decompression and fusion surgery. Discussion: Following decompression and fusion of involved cervical spine disc pathology, the patient had complete recovery of his right foot drop. Conclusions: Central causes, although rare, should be considered in the differential diagnosis of foot drop. Causes could be due to the compression effect of the cortico-spinal tract of the cervical spinal cord. Satisfactory results can be achieved upon correcting the causative lesion. 

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  • 13.
    Al-Yahri, Omer
    et al.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Farghaly, Hanan
    Department of Lab Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
    Murshed, Khaled
    Department of Lab Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
    Zirie, Mahmoud A.
    Department of Endocrinology, Hamad General Hospital, Doha, Qatar.
    Al Hassan, Mohamed S.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    First ever case report of co-occurrence of hobnail variant of papillary thyroid carcinoma and intrathyroid parathyroid adenoma in the same thyroid lobe2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 70, s. 40-52Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: The hobnail variant of papillary thyroid cancer (PTC) is rare. Intrathyroid parathyroid adenoma (ITPA) is also rare. Co-ocurrence of PTC and ITPA in the same thyroid lobe is extremely rare. Likewise, primary hyperparathyroidism with such non-medullary thyroid carcinoma is rare. The specific molecular profile of hobnail PTC (HPTC) is different from the classic, poorly differentiated and anaplastic variants and may contribute to its aggressive behavior. HPTC's genetic profile remains unclear. Presentation of case: A 61-year-old woman presented to our endocrine clinic with generalized aches, bone pain, polyuria, and right neck swelling of a few months’ duration. Laboratory findings revealed hypercalcemia and hyperparathyroidism. Ultrasound of the neck showed 4.6 cm complex nodule within the right thyroid lobe. Sestamibi scan suggested parathyroid adenoma in the right thyroid lobe. Fine-needle aspiration (FNA) revealed atypical follicular lesion of undetermined significance. She underwent right lobectomy, which normalized the intraoperative intact parathyroid hormone levels. Final pathology with immunohistochemical stains demonstrated HPTC and IPTA (2 cm each). Next-generation sequencing investigated the mutation spectrum of HPTC and detected BRAFV600E mutation. Conclusions: A parathyroid adenoma should not exclude the diagnosis of thyroid carcinoma. Thyroid evaluation is needed for patients with primary hyperparathyroidism to prevent missing concurrent thyroid cancers. Cytomorphologic features to distinguish thyroid from parathyroid cells on FNA cytology must be considered. Immunohistochemical stains are important. BRAFV600E is the most common mutation in HPTC. This is possibly the first reported case of HPTC and ITPA co-occurring within the same thyroid lobe. Studies that define other molecular abnormalities may be useful as therapeutic targets. © 2020 The Author(s)

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  • 14. Arshad, W.
    et al.
    Amir, A.
    Malik, M. N.
    Maqbool, S.
    Anwar, M. I.
    Lee, Ka Yiu
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Rare case of mixed epithelial and stromal tumor (MEST) of the kidney and its diagnostic and therapeutic approach: A case report2023Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 102, artikel-id 107882Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction and importance: Mix epithelial and stromal tumor (MEST) is a benign biphasic renal lesion composed of solid as well as cystic components lining tubular and cystic spaces of kidney. There are very few cases of such variety have been reported with perspective to renal involvement. Herein we have reported a rare case of MEST involving left renal tissue and sparing surrounding tissues. Case presentation: A 20 years old female presented to surgical outpatient department with complaint of amenorrhea and left flank pain as well as heaviness for 1 year. Patient was vitally stable and cooperative. On physical examination left flank mass was palpated and ultrasound and CT scan imaging was also showing left renal mass confined to upper, middle and lower portion of the kidney while renal capsule, adrenal gland and ureter were spared. On histological examination showed multi-cystic structures with variably sized simple cysts lined by hobnailed epithelium with clear cells. Septa show ovarian type fibrous stroma with variable inflammation and immature nephrogenic elements. A final diagnosis of MEST was made. Therefore, radical nephrectomy with trans-peritoneal approach was done. Clinical discussion: MEST is a benign tumor of renal tissue that is confined to the renal parenchyma rather than involvement of surrounding structures as occurred in our case. Due to benign nature of the disease involvement of renal capsule and adrenal gland is less likely. The choice of treatment is radical nephrectomy through transperitoneal approach. Conclusion: MEST is a rare diagnosis thought case now start reporting since last decade, however, it's still a rare entity to be reported. USG and CT scan are investigating modalities along with histopathological correlation to reach the diagnosis. 

  • 15.
    El Baba, Hamizah
    et al.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Al Moudaris, Ahmed
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Samra, Hayan Abo
    Department of Laboratory Medicine and Pathology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Alateeg, Layth
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Al-Yaseen, Mohammed
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar ; Weill Cornell Medicine–Qatar, Doha, Qatar.
    First case of chronic cell leukemia discovered incidentally in extra-saccular inguinal lymph node during laparoscopic bilateral inguinal hernia repair: Case report and literature review2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 88, artikel-id 106558Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Chronic cell leukemia discovered incidentally in extra-saccular inguinal lymph node during laparoscopic bilateral inguinal hernia repair is extremely rare. Presentation of case: 62-year-old Romanian male presented at the outpatient general surgery clinic in April 2019 complaining of bilateral inguinal swelling that gradually increased in size mainly on right side and was diagnosed with bilateral inguinal hernia. During the laparoscopic repair of the hernia, a large lymph node in the left femoral canal was incidentally observed. Histopathologic, immunohistochemical, and flowcytometric evaluation of the excised specimen confirmed chronic lymphocytic leukemia/small lymphocytic lymphoma. Discussion: Whole body CT showed supra and infra-diaphragmatic lymphadenopathy, and few small subsolid pulmonary nodules, possibly metastatic. Splenomegaly and pancreatomegaly were also noted, suggesting lymphomatoid infiltration. Conclusion: There is need for cautious inspection and meticulous palpation of the inguinal area for any lymphadenopathy during routine inguinal hernia repair.

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  • 16.
    Galos, Peter
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Enblad: Neurokirurgi.
    Hultström, Michael
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Dimopoulou, Angeliki
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Eggertsen, Gösta
    Karolinska Inst, Dept Lab Med, Solna, Sweden..
    Urdzik, Jozef
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Gastrointestinalkirurgi.
    von Seth, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Case report: An unusual presentation of renal hypertension after damage control surgery2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 82, artikel-id 105872Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION AND IMPORTANCE: Hypertensive crisis may be a life-threatening condition to any patient and represents an even more serious condition in trauma patients following severe hemorrhage. CASE PRESENTATION: We present a case were surgical drape packing induced hypertensive crisis in a trauma patient, recently resuscitated from abdominal hemorrhage. CLINICAL DISCUSSION: We argue that direct compression of the kidney by the surgical drapes induced hypersecretion of renin with a mechanism equal to Page kidney. The hypertensive crisis as well as the hyperreninemia was resolved after removing the surgical drapes, and the patient's condition returned to normal without any sequelae. CONCLUSION: We encourage considering this unusual but important complication when packing of the abdomen has been carried out, and strongly recommend ruling out renin-mediated hypertension as a cause of post-operative hypertension in such cases.

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  • 17.
    Hamid, Salik
    et al.
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken ViN.
    Gadré, Ashok
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken ViN. Linköpings universitet, Medicinska fakulteten.
    Fornander, Liselott
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi.
    Sjöwall, Johanna
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för inflammation och infektion. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Medicincentrum, Infektionskliniken i Östergötland.
    Muhrbeck, Måns
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken ViN.
    Clostridium septicum myonecrosis following gardening: A case report2023Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 105, artikel-id 108000Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction and importance

    Clostridial myonecrosis (CM), or gas gangrene, is a rare necrotizing muscle infection caused most often by Clostridium perfringens or C. septicum. Inoculation can occur either traumatically or spontaneously. CM has a high mortality rate if not treated promptly.

    Case presentation

    A 64-year-old male presented to the emergency department (ED) with sudden onset left flank pain and fever. Repeated CT scans demonstrated progressive edema around the left iliopsoas muscle with gas formation and bleeding. The patient received intravenous fluids, meropenem, and clindamycin. Emergency laparotomy was performed on suspicion of necrotizing fasciitis and revealed a necrotic left iliopsoas muscle which was partially excised. Blood cultures were positive at 12 h with growth of C. septicum. Prolonged stay in the intensive care unit, and six additional surgical interventions to the abdomen, left thigh, and flank were needed. The patient was discharged after four months to a nursing home.

    Clinical discussion

    C. septicum CM more often occurs spontaneously and is associated with colorectal malignancy. However, for our patient, CT colonography and proctoscopy did not reveal any pathology. Therefore, we believe the CM resulted from an injury the patient sustained while working in his backyard, either a cut from barbed wire on his arm or from soil contaminating his psoriatic lesions. Successful outcomes for patients with CM require a high index of suspicion, timely treatment with antibiotics, and repeated surgical debridements.

    Conclusion

    This case report describes the presentation and management of a presumably injury-related CM caused by C. septicum.

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  • 18.
    Mahmoud, Waleed
    et al.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    Petkar, Mahir
    Department of Laboratory Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
    Al Hassan, Mohamed S.
    Department of General Surgery, Hamad General Hospital, Doha, Qatar.
    Two separate tumours—Concomitant papillary carcinoma in thyroglossal duct cyst and right thyroid lobe: Case report and review of the literature2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 73, s. 257-262Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Introduction: Malignancy of thyroglossal duct cyst (TGDC) is rare, usually as papillary carcinoma, and less frequently as squamous cell or follicular carcinoma. TGDC carcinoma can present as a mass arising from the neck, with or without compression symptoms. Papillary carcinoma in TGDC concomitant with another papillary carcinoma in the thyroid gland is extremely rare. Presentation of case: : 31 years old female with a neck lump since 2 years, slowly increasing in size, with mild pain while drinking fluids, and no change of voice. No past history of neck irradiation or family history of thyroid cancers. Ultrasonography of the neck showed TGDC and right thyroid nodule. Ultrasound guided fine needle aspiration and cytology of the TGDC showed TGDC papillary carcinoma. The patient underwent Sistrunk's procedure and total thyroidectomy. Discussion: Rare case of classic papillary carcinoma arising in TGDC, concomitant with another papillary carcinoma in the right thyroid nodule. Preoperative work up included US and fine needle aspiration and cytology (FNAC). Post-operative histopathology showed papillary carcinoma in the TGDC; and another in the right thyroid lobe that was a papillary carcinoma with follicular patterns. Conclusions: TGDC carcinoma concurrent with another carcinoma in the right thyroid lobe as two separate tumours are extremely rare. All patients should undergo Sistrunk's procedure, and total thyroidectomy for the thyroid tumour. Follow-up requires thyroxine replacement therapy to treat hypothyroidism and to suppress TSH in order to prevent recurrence; and neck ultrasound and thyroglobulin tumour marker to detect recurrence if present. © 2020 The Authors

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  • 19.
    Mahmoud, Waleed
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Hassan, Sara
    Department of Breast Surgery, Hamad Medical Corporation, Doha, Qatar.
    Alatasi, Sali
    Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
    Almerekhi, Haya
    Department of Clinical Imaging Service, Hamad Medical Corporation, Doha, Qatar.
    Junejo, Kulsoom
    Department of Breast Surgery, Hamad Medical Corporation, Doha, Qatar.
    Giant mammary hamartoma in a middle aged female: Case report and review of literature of the last 15 years2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 78, s. 145-150Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Mammary hamartoma is a benign rare tumour occurring in both sexes, with size range mostly between 2–4 cm. Giant breast hamartoma (GMH) is very rare and can reach unexpected sizes in women. Presentation of the case: A 26 year old Egyptian female presented with left breast lump since 3 years, gradually increasing in size, with no other associated complaints. No family history of breast cancer, she did not smoke or consume alcohol, and had no past medical history. Examination revealed a large soft freely mobile mass (12 × 9 cm) in the lower outer quadrant of the left breast at the 3–6 o'clock position. There were no palpable axillary lymph nodes in both sides. Nipples and right breast were normal. Discussion: The diagnosis of GMH can be made by examination and imaging only. The specific features that appear in mammogram and ultrasound can be used to reduce the need for core biopsy in hamartoma. Wide local excision is curative. We include a review of the literature of cases of GMH > 10 cm published during the last 15 years. Conclusion: A non-invasive mammogram and ultrasound provide sufficient evidence of the tumour, hence core biopsy might not be critically required. However, if a breast hamartoma is still clinically suspected but with inconclusive or unequivocal mammographic and ultrasonographic features or if there is suspicion of dysplasia, then invasive core biopsy is justified. Recurrence is low and prognosis is good. 

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  • 20. Maqbool, S.
    et al.
    Huma, A.
    Anwar, M. I.
    Khan, M. A.
    Lee, Ka Yiu
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Ovary and fallopian tube as contents of indirect inguinal hernia: A case report2022Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 100, artikel-id 107733Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction and importance: Ovarian and fallopian tube indirect inguinal hernias are rare hernias encountered on surgical floor. Herein, we are reporting a rare happening of obstructed ovarian and fallopian tube indirect inguinal hernia in an unmarried female. Presentation of case: A 19 years old unmarried female presented to surgical emergency with complain of swelling in left inguinal region that was about 3 × 3 cm on visual inspection from last 4 days that was associated with menstruation. Abdominal ultrasound (USG) was showing left ovarian and fallopian tube indirect inguinal hernia with preserved internal follicles and intact vasculature. The diagnosis of obstructed ovarian and fallopian tube indirect inguinal hernia was made and diagnostic laparoscopy and left sided hernioplasty was performed. Ovary was retrieved back into abdominal cavity and stitched to lateral pelvic wall. Discussion: Inguinal hernia itself is a rare happening in females and the presence of ovary and fallopian tube along with other hernial content can become a topic of discussion due to rarity of this case. It is of paramount significance to diagnose such cases with great expertise in order to avoid long term complications in terms of preserving fertility among females. Early utilization of radiological investigations like USG abdomen and laparoscopic retrieval of adnexal structures are standard approach in management of such cases. Conclusion: Presence of ovary and fallopian tube in indirect inguinal hernia is a rare happening that need to be diagnosed and treated at earliest to avoid infertility among females. 

  • 21.
    Mohamed, Sugad
    et al.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Ben-Gashir, Mohamad
    Department of Laboratory Medicine & Pathology, Hamad Medical Corporation, Doha, Qatar.
    Abusabeib, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Ossifying fibromyxoid tumor in the lower extremity mimicking a sebaceous cyst: Case report and literature review2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 79, s. 37-43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Ossifying fibromyxoid tumor (OFMT) is an uncommon soft tissue neoplasm, with malignant potential and unclear histogenesis. OFMT exhibits a spectrum of histopathologic features including benign (typical), atypical and malignant subtypes. To the best of our knowledge, about 300 cases have been reported worldwide. We present the first reported case from Qatar. Presentation of case: A 36-year old Egyptian male, with no comorbidities was admitted electively as a day case for excision of left thigh suspected sebaceous cyst under local anesthesia. History, physical examination and soft tissue ultrasound imaging were unremarkable. Intraoperatively, the patient was found to have a hard-calcified mass adhering to the surrounding fascia which was excised en bloc. The histopathology result was of ossifying fibromyxoid tumor. The post-operative course along with 40 months follow-up were uneventful in terms of surgical complications and recurrence. Discussion: OFMT has marked features in terms of cytology. Though it is difficult to diagnose preoperatively, it should be considered in tumors involving soft tissue that demonstrate prominent ossification and calcification. Conclusion: OFMT is a rare soft tissue neoplasm, and should be considered as a differential diagnosis in any subcutaneous swelling with a bony component. All OFMT patients should undergo a long course of follow-up to rule out and assess any recurrence or metastasis in the malignant variants. 

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  • 22.
    Mohamed, Walla
    et al.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar ; Weill Cornell Medicine, Doha, Qatar.
    Al Hassan, Mohamed S.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Sibira, Rayan M.
    Department of Laboratory Medicine & Pathology, Hamad General Hospital, Doha, Qatar.
    Abusabeib, Abdelrahman
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Water clear cell ectopic non-iatrogenic giant parathyroid adenoma in sternohyoid muscle with thyroid nodule and asymptomatic hypercalcemia due to primary hyperparathyroidism: Case report and literature review2021Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 86, artikel-id 106295Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Ectopic parathyroid gland is not uncommon, and is associated with primary hyperparathyroidism. Giant parathyroid adenoma (PA) and concurrent presence of enlarged thyroid nodule increases the probability of ectopic location. The combination of a giant PA that is ectopic (within the strap muscle) in the neck is very rare, especially in cases with no previous surgery. The rare histopathological findings of the current case, water clear cell parathyroid adenoma (WCCPA), could explain the patient's presentation, since it has low endocrine function. Case presentation: A 56-year-old Qatari female on routine visit to primary health care physician for hypertension, was incidentally discovered to be hypercalcemic and was referred to the emergency department of our institution. Neck ultrasound showed a thyroid nodule on the left side, but 99mTc-sestamibi scintigraphy identified a left PA. FNAC of the thyroid nodule showed that it was a colloid nodule. She underwent left hemithyroidectomy and excision of left PA. Intraoperatively, the PA was giant and in the sternohyoid muscle. Intraoperative monitoring of intact PTH (IOiPTH) confirmed successful excision. Discussion: Ectopic giant parathyroid adenoma is rare especially with the intramuscular location in sternohyoid muscle in the neck without previous neck surgeries. The presence of thyroid nodule could be a precipitating factor for migration of the PA. Preoperative assessment with the radiological image is crucial for diagnosis but sometimes fail to localized the PA. Conclusion: Giant asymptomatic PA with long standing low function before hyperfunctioning should raise the suspicion of WCCPA. If diagnosis is confirmed, metastasis from a clear cell renal cell carcinoma should be ruled out. 

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  • 23. Nasser, Hassan
    et al.
    Ivanics, Tommy
    Leonard-Murali, Shravan
    Genaw, Jeffrey
    A case report of an adjustable gastric band erosion and migration into the jejunum resulting in biliary obstruction2019Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 64, s. 139-142Artikel i tidskrift (Refereegranskat)
  • 24. Nasser, Hassan
    et al.
    Ivanics, Tommy
    Leonard-Murali, Shravan
    Shakaroun, Dania
    Woodward, Ann
    Emphysematous gastritis: A case series of three patients managed conservatively2019Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612Artikel i tidskrift (Refereegranskat)
  • 25.
    Shahid, Fakhar
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Ben-Gashir, Mohamed
    Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
    Abdelaal, Abdelrahman
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Laparoscopic hydrocelectomy of the canal of Nuck in adult female: Case report and literature review2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 66, s. 338-341, artikel-id S2210-2612(19)30674-1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Among adult females, Hydrocele of Canal of Nuck (HCN) is a very rare condition. The majority of the reported cases of HCN were not conclusively diagnosed until surgery was performed on a suspected inguinal hernia. To the best of our knowledge, this is the first case of laparoscopically operated HCN in adult female in Middle East and North Africa Region, and the fourth such case worldwide.

    PRESENTATION OF CASE: A 36-year-old female presented with a painful small swelling in the right groin of 3 months duration. The swelling extended to the right labia majora while standing, and disappeared when the patient was in prone position. There was no lymph node enlargement, no other masses in the abdomen, and no swelling in the contralateral side. Ultrasonography was undertaken and the patient was admitted electively for laparoscopic exploration and repair of non-complicated right inguinal hernia. She was known to have dyslipidemia on medications. Further history and physical examination were unremarkable. Intraoperatively it was diagnosed to be right-sided HCN which was excised and repaired by mesh fixation using transabdominal preperitoneal (TAPP) approach. Her follow up course was unremarkable.

    CONCLUSIONS: This case expands the clinical and intraoperative potential differential diagnosis of adult female groin masses. Surgeons should consider such cases when they observe such swellings intraoperatively. Laparoscopic TAPP approach in such cases is a superior diagnostic and treatment modality.

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  • 26.
    Säll, Olof
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Cha, Soon-Ok
    Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Holmberg, Hans
    Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Diagnostic challenges in a patient with myocardial tuberculoma: A case report2016Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 29, s. 201-203Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Tuberculosis can affect any organ of the body, including the heart.

    PRESENTATION OF CASE: An 18-year old woman presented with a multifocal tuberculosis infection involving abdominal lymph nodes, a sternotomy wound, an abscess of the abdominal wall and most notably a myocardial tuberculoma. Establishing the diagnosis of the myocardial tuberculoma was challenging mainly due to the location within the heart. Initially a diagnostic percutaneous femoral vascular catheter guided biopsy of the right atrial mass was performed, but later open surgery involving median sternotomy was needed. The patient recovered fully after surgery and nine months treatment with anti-tuberculosis drugs.

    DISCUSSION: The optimal length of treatment for myocardial tuberculoma is unknown. Medical treatment for six months might be enough regardless whether surgery is performed or not.

    CONCLUSION: Myocardial tuberculoma requires culture from the infected tissue for confirmed diagnosis and might be successfully treated with anti-tuberculosis drugs only. Indications for surgery include uncertain diagnosis, poor response to medical treatment or cardiac complications. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

  • 27.
    Tocco-Tussardi, Ilaria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Maxillofacial Surg, S-75185 Uppsala, Sweden.;Univ Padua, Dept Neurosci, Clin Plast & Reconstruct Surg, Via Giustiniani 2, I-35128 Padua, Italy..
    Mobargha, Nathalie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Maxillofacial Surg, S-75185 Uppsala, Sweden..
    Bassetto, Franco
    Univ Padua, Dept Neurosci, Clin Plast & Reconstruct Surg, Via Giustiniani 2, I-35128 Padua, Italy..
    Vindigni, Vincenzo
    Univ Padua, Dept Neurosci, Clin Plast & Reconstruct Surg, Via Giustiniani 2, I-35128 Padua, Italy..
    Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report2016Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 28, s. 117-120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Nevoid hyperkeratosis of the nipple and/or areola (NHNA) is a benign lesion with a female predominance and an aesthetically disturbing appearance. Spontaneous remission is not reported and medical treatments proposed so far have shown variable results. PRESENTATION OF CASE: We describe a rare case of an extensive variant of NHNA covering almost the entire breasts' surface. At present, only three other reports are present in the literature. Medical treatment proved not completely effective and the patient was also affected by a significant breast asymmetry hypertrophy. Therefore, NHNA was managed surgically with excision of the areolar affected portions while performing breast reduction-lift. The result was satisfactory and without recurrence of lesions at 5-year follow-up. DISCUSSION: This case reported favorable outcomes of surgery for NHNA. Reports of success with these procedures are still limited, but the promising results in terms of radicality and aesthetic outcome suggest it should be offered to patients as a viable therapeutic option. CONCLUSION: Indications for surgical treatment of NHNA can be: unsatisfying response to topical agents; young patients who want to restore the aesthetic appearance of the breast; and patients with concomitant indication for corrective surgery of the breast. Advantages are: predictable time of healing; predictable final result; radical excision of the affected tissue; and possibility of histologic analysis of the whole areola. In rare cases of lesions extending to the breast, preliminary treatment with topical agents can limit the extent of excision. Management and treatment should always be tailor-made for each individual case.

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  • 28.
    Toffaha, Ali
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsovetenskaper. Högskolan i Skövde, Forskningsmiljön hälsa, hållbarhet och digitalisering. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Aleter, Ammar
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    What you see might not be what you get: Discrepancies between intraoperative findings and preoperative diagnosis of ovarian tumors. Appendicular mucocele presenting as an adnexal mass - Case report and review of literature2020Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 75, s. 543-549Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Adnexal masses include those affecting the ovary or fallopian tubes. We report a unique case with discrepancy between the pre-operative diagnosis (adnexal mass) and the post-operative definitive findings (appendicular tumor invading ovary). We also employ a literature review to provide four scenarios of uncertainty that are encountered between appendiceal and adnexal masses. Presentation of case: A 58 year old female with history of treated left colon cancer, referred to the gynecology clinic with intermittent vaginal bleeding for 5 days. Examination showed lower abdominal midline mobile non-tender mass, bulky uterus and right adnexal fullness. Other history, physical examination and laboratory tests were unremarkable. US and MRI suggested a right ovarian mass and uterine fibroids. Intraoperatively, she had a right ovarian large mobile multi-locular mass. The appendix was adherent to the ovary, with mucus extruding through its tip. Appendectomy was undertaken alongside hysterectomy and bilateral salpingo-oophorectomy. Histopathology showed right ovarian mucinous neoplasm, but the origin was a low-grade appendiceal mucinous neoplasm (pT4aNxMx). The patient was recurrence free across 3 years of follow up. Discussion: Appendicular mucocele can present as adnexal mass. Pre-operative diagnosis and differentiation is sometimes difficult. Conclusion: Adnexal masses need careful pre-operative diagnoses. The definitive management is based on the final intra- and post-operative findings. As a variety of scenarios could be encountered, there could be a need to involve general/colorectal surgeons in case of appendicular tumors. Patients should be counselled regarding the possible change in intra-operative plan, and are better operated upon in facilities with appropriate teams and equipment. 

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  • 29.
    Toffaha, Ali
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Elaiwy, Orwa
    Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
    Obaid, Munzir
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Al-Yahri, Omer
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Abdelazim, Sherif
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    First sliding Amyand hernia harbouring appendicular schistosomiasis: Case report2019Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 63, s. 143-146Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Amyand's hernia (AH) is rare, schistosomiasis of the appendix is very uncommon, and both conditions coexisting together is an extremely rare event. Pre-operative diagnosis of each of the two conditions is usually difficult. To the best of our knowledge, the current paper is first to report both these two conditions in coexistence. Presentation of case: A 31-year old man who had no comorbidities was admitted electively as a day case of non-complicated right indirect inguinal hernia. Further history and physical examination were unremarkable. Intraoperatively the patient was found to have right sliding AH with appendicular schistosomiasis (AS). The patient underwent Lichtenstein repair of the hernia with appendectomy. On follow up he was referred to infectious disease clinic, and the post-operative course was uneventful. Conclusions: Intraoperative identification of non-typical hernia sac before its opening should alert the surgeon to the possibility of sliding hernia and the presence of an organ as a part of the sac. Rare causes of appendicular masses like schistosomiasis granuloma should be considered in endemic areas or immigrants from these areas, despite the difficulty of preoperative diagnosis. Management should follow general guidelines of appendectomy, hernia repair and dealing with the associated pathology if present. 

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  • 30.
    Yamamoto, Shinji
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi. Department of surgery, Uppsala University Hospital, Uppsala, SE-75185, Sweden..
    Nelander, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Ectopic pregnancy in simultaneous pancreas-kidney transplantation: A case report2016Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 28, s. 152-154Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: We present a case report of ectopic pregnancy (EP) after simultaneous pancreas-kidney transplantation (SKPTx). PRESENTATION OF CASE: A 33-year-old female status post SKPTx suddenly got abdominal pain in the lower level. She had high human chorionic Gonadotropin test. Ultrasonography revealed that there was no fetus in the uterus but a dilated right fallopian tube, which strongly suggested ectopic pregnancy. An emergency operation was performed and a dilated right side uterine tube was found with adhesions to her transplant. Salpingectomy was performed and no visible injury to the pancreas was found by the procedure. Pathological evaluation showed ectopic pregnant fetus, and no pancreas dysfunction was observed after the operation. DISCUSSION: This is the first case and operation report of EP after SKPTx. We should consider various causes of acute abdomen as well as several pathological condition in the transplanted pancreas such as pancreatitis, abscess, and thrombosis in vessels in the organ. Moreover, transplanted pancreas in abdomen is easily misrecognized as adipose tissue and there is high risk that the organ to get injured surgically. CONCLUSION: EP should be included in the different diagnosis in SKPTx female patients who get acute abdominal pain. It is highly desirable that transplant surgeon is included in the operation team for EP of these patients. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

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