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A W Meshikhes

Publications and source records attributed to A W Meshikhes.

5 recordsLinked to original sources

Sickle cell disease and the general surgeon.

Sickle cell disease (SCD) is a common genetic disorder which represents a major medical problem in certain parts of the world. It is characterized by chronic haemolytic anaemia and vaso-occlusive crises, which can lead to widespread vascular occlusion by sickled red blood cells leading to multiple organ infarctions. In this respect, SCD can be considered as a multisystem disease presenting, to various surgical disciplines, a wide variety of surgical ailments. As surgical management of these patients is associated with high morbidity and mortality, close collaboration between medical and surgical services is essential. Greater population mobility makes recognition of the surgical implications of this disease of paramount importance in surgical practice. This article reviews surgical problems with which SCD patients may present to general surgeons and discusses their management.

Anemia, Sickle Cell

Laparoscopic cholecystectomy: the Dammam Central Hospital experience.

Over a one year period (June 1992-June 1993), 260 patients (208 females and 52 males) with mean age of 37 years (range 13-80), underwent laparoscopic cholecystectomy (LC) for symptomatic gallstones. Thirty patients were admitted as emergency (20 acute cholecystitis, 10 acute pancreatitis). The procedure was performed successfully in 232 cases (89%). In 28 patients (18 electives, 10 emergencies), the procedure was converted to open for a variety of reasons, difficult anatomy being the commonest. Our mean operative time was 99.9 minutes (range 30-290 minutes). There were 3 major complications (2 common bile duct injuries and one abdominal aortic injury) and 4 minor complications (2 wound infections, one prolonged ileus and one chest infection). There was one death due to sickle cell crisis on the fifth post-operative day. The mean hospital stay was 2.3 days and 6.5 days for LC and converted cases, respectively. Our results suggest that laparoscopic cholecystectomy can be offered and conducted safely and effectively in the great majority of patients presenting acutely or electively with cholelithiasis, and that the results we achieved during the first year of our experience with LC is comparable to those reported from Europe and North America.

Adolescent