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Abdul-Wahed N Meshikhes

Publications and source records attributed to Abdul-Wahed N Meshikhes.

18 recordsLinked to original sources
PubMed2006

Laparoscopic diagnosis of splenic tuberculosis.

Isolated tuberculous splenic microabscesses are uncommon except in immunocompromized patients. The diagnosis is often made after splenectomy and histologic examination of the spleen. We report here a case of splenic tuberculosis in an immuno-competent patient. The diagnosis was made solely by laparoscopic biopsy of the spleen without the need for splenectomy. The patient was started on antituberculosis therapy with marked recovery. We believe that this might be the first reported case of isolated splenic tuberculosis ever diagnosed by laparoscopy only.

Abscess↗
PubMed2006

Pseudomyxoma peritonei.

Pseudomyxoma peritonei is very rare, and its exact pathogenesis is unknown. It is characterized by intra-abdominal extracellular gelatinous fluid collections. We report a case of pseudomyxoma peritonei in a 38-year-old Saudi male who presented with right iliac fossa mass and weight loss. He was treated initially as an appendicular mass and computed tomography was helpful in making the diagnosis. He was treated by laparotomy, right hemicolectomy and omentectomy, but no perioperative intraperitoneal chemotherapy was instilled. He received postoperative chemotherapy and remained alive with no recurrence at 18-month follow-up.

Adenocarcinoma, Mucinous↗
PubMed2005

Fibrous histiocytoma of the breast.

Two Saudi females aged 26 and 14 years presented with giant fibroadenomas. The histology after surgical excision revealed benign fibrous histiocytomas. Patient one remained well with no apparent recurrence after 5 years of the initial excision. However, in patient 2 the benign fibrous histiocytoma recurred with low-grade malignancy after a year of the initial excision. A high-grade recurrence developed after 3 months of the second excision. This was treated by radical wide excision. It was felt later that mastectomy was more appropriate and therefore was performed. The second patient highlights the fact that malignant histiocytoma can occur in the pediatric age group and that the initial surgical treatment of benign fibrous histiocytoma should be aggressive to avoid recurrence and development of malignant changes. We believe that our second patient is the youngest age ever reported in the literature with malignant fibrous histiocytoma.

Adolescent↗
PubMed2004

Pancreatic pseudopapillary tumor in a male child.

CONTEXT: Solid-pseudopapillary tumors are exceedingly rare in males. They are almost exclusively encountered in young females (mean age 26 years) and have a female predominance. It is most commonly detected incidentally, but may occasionally present with sudden pain or symptoms related to compression of adjacent organs. CASE REPORT: We report the case of a 12-year-old boy having a solid-pseudopapillary tumor of the pancreas presenting with a tender upper abdominal mass following a slight trauma. Radiological investigation showed the lesion to be a cystic mass arising from the body and the tail of the pancreas. The child underwent emergency distal pancreatectomy and has remained free of recurrence for 3 years. CONCLUSION: In the pediatric age group, solid-pseudopapillary tumors may present acutely with a tender abdominal mass following a slight trauma. Awareness of this fact will allow appropriate and prompt management to be undertaken.

Child↗
PubMed2004

Concurrent papillary and medullary thyroid carcinomas with mixed metastases to lymph nodes.

We report here a rare concurrence of medullary and papillary carcinomas of the thyroid in a 39-year-old Saudi male. He presented with a solitary nodule of the right thyroid lobe and underwent total thyroidectomy based on the cytological diagnosis of papillary carcinoma. Subsequent detailed histopathologic examination of the thyroid revealed 2 different types of malignancies in the 2 lobes papillary cancer in the right and medullary cancer in the left lobe. A single small lymph node showed metastatic replacement by both cancers. The extreme rarity and the interesting pathological features of such combinations are discussed.

Adult↗
PubMed2004

Combined parathyroid adenoma and an occult papillary carcinoma.

Although the pathological association of thyroid and parathyroid disease is common, the association of both parathyroid adenoma and thyroid cancer is rare. We report here a case of a 45-year-old Saudi woman who was diagnosed to have primary hyperparathyroidism due to a single parathyroid adenoma as confirmed biochemically and radiologically. At operation, the adenoma was found to be an intrathyroid and therefore a thyroid lobectomy was performed. Histology of the excised lobe revealed in addition to the intrathyroid parathyroid adenoma a concurrent occult thyroid papillary carcinoma. This interesting association is discussed based on a literature review.

Carcinoma, Papillary↗
PubMed2004

The pattern of indications and complications of splenectomy in Eastern Saudi Arabia.

OBJECTIVE: The indications for splenectomy have changed over the past decade. Trauma and hematological diseases are emerging as common indications since the early eighties of the last century. This study looks at the pattern of indications and complications of splenectomy at Dammam Central Hospital, Dammam, Eastern Province, Kingdom of Saudi Arabia. METHODS: A retrospective study of all patients who underwent splenectomy at Dammam Central Hospital over the 5-year period (1996-2000). RESULTS: There were 55 patients (47 males and 8 females) who underwent splenectomy over the study period. The mean age was 57.5 (range 4-65) years. The most common indication was trauma (43.6%) followed by hematological reasons (25.5%), which were mainly in sickle cell disease (SCD) patients (N=9). Splenic sequestration crises were the most common indication in SCD patients (77.7%). The mean weight of the excised spleen was 882.7 (range 85-1350) grams. There were 16 (29%) postoperative complications mostly encountered in patients with portal hypertension (46.2%). There were 2 deaths (3.6%) as a result of pulmonary embolism in a trauma patient and multi-organ failure in SCD. There was no reported postsplenectomy sepsis after a follow-up period of 18-72 months. CONCLUSION: The most common indication for splenectomy in Dammam is abdominal trauma, followed by hematological diseases. Splenectomy in adult SCD population is uncommon. Conventional splenectomy has 29% complication rate especially in patients with portal hypertension. This calls for rapid introduction of minimally invasive approach to reduce the morbidity associated with open splenectomy.

Adolescent↗
PubMed2003

Pancreatic pseudocyst.

Gallstones cause more than two-thirds of the acute pancreatitis episodes in the Kingdom of Saudi Arabia (KSA). The majority of these attacks are often mild and self-limiting. However, some are associated with complications; most common of which is development of pancreatic pseudocyst. This complication was reported to be rare in some areas of KSA. The author reports his personal experience with pancreatic pseudocysts that he encountered over 9 years of surgical practice in one of the busiest hospitals in the Eastern Province of KSA and discusses various management options.

Adult↗
PubMed2003

Pigment polyp in the common bile duct.

We report here a case of a young female with sickle cell disease and a past history of open cholecystectomy 10 years ago presenting with intermittent upper abdominal pain and jaundice. Abdominal ultrasonography revealed a dilated biliary tree with the possibility of a stone in the proximal common bile duct, but cholangiopancreatography showed a polypoid lesion at the junction of the common hepatic and common bile ducts. Biopsy of the lesion was benign. She underwent bile duct exploration and excision of what proved to be a pigment'polyp arising from the cystic duct stump. This is the first reported case of a pigment polyp encountered in sickle a cell disease population.

Adult↗
PubMed2002

Retroperitoneal abscess as an initial presentation of cecal carcinoma.

We report an unusual case of cecal carcinoma presenting first time as retroperitoneal abscess. As the patient was septic on presentation and the underlying cancer was not clear, she was treated initially by extraperitoneal drainage of the abscess. She later underwent a palliative right hemicolectomy. She presented a month later with recurrence at the drainage site. This case highlights this unusual initial presentation of right colonic cancer, the diagnostic dilemma and the poor prognosis associated with it.

Abdominal Abscess↗
PubMed2002

Efficacy of Daflon in the treatment of hemorrhoids.

OBJECTIVE: To demonstrate the value of Daflon in the management of hemorrhoidal symptoms in Saudi patients attending the Surgical clinic. METHODS: This is a prospective clinical study of 105 consecutive patients suffering from hemorrhoidal problems including thrombosed piles. Detailed history and proctoscopic examination to determine position, size, and degree of hemorrhoids was conducted in all patients attending the Surgical Clinic at Dammam Central Hospital, Dammam, Kingdom of Saudi Arabia (KSA). The study was conducted over a 6-months period (December 2000 to May 2001). All were started on Daflon; 2 tablets twice daily for 4 weeks and were followed up weekly during the study period and proctoscopic examination was conducted at each consultation. RESULTS: The mean age was 35 (range 19-70) years. The majority (77%) suffered congested hemorrhoidal disease and only 8% had thrombosed piles. Previous surgery for piles was noted in 11%. Concomitant medical diseases were present in 10%. The degrees of piles were first degree (23 patients), 2nd degree (73), 3rd degree (9) and 4th degree (0). There was a statistically significant (p<0.001) improvement in pain, heaviness, bleeding, pruritus, and mucosal discharge from baseline to last visit. There was also a significant (p<0.001) improvement on the proctoscopic appearance. Five patients failed to improve on Daflon; therefore, they underwent surgery. The side effects of Daflon (mainly gastrointestinal symptoms) were encountered in 5 patients but did not force interruption of the medication. CONCLUSION: Daflon is a very safe and effective drug in the treatment of all hemorrhoidal symptoms in the population of Eastern KSA.

Adult↗