Biomedical subjects

Khalid R Murshid

Publications and source records attributed to Khalid R Murshid.

7 recordsLinked to original sources

PubMed2005

Post appendectomy small bowel obstruction.

OBJECTIVE: Postoperative small bowel obstruction is one of the adverse effects of appendectomy but its frequency varies from center to other. This study was conducted to determine the incidence of this complication among our patients who had appendectomy and identify the factors which may increase the risk. METHODS: Case notes of patients who underwent appendectomy from January 1998 to December 2003 in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia were reviewed. Patients readmitted for adhesive small bowel obstruction were traced and their clinical data were analyzed. RESULTS: Six hundred and seven patients were eligible for the study. Six patients (1%) developed intestinal obstruction. Frequency of readmission of patients with features of intestinal obstruction ranged from 1-6 (mean of 2 times). CONCLUSION: The incidence of small bowel obstruction after appendectomy is low. The main risk factors were reviewed and measures to avoid them were suggested.

Adolescent↗

PubMed2005

Validity of leukocyte count to predict the severity of acute appendicitis.

OBJECTIVE: To ascertain whether white blood cell (WBC) count with differential analysis may predict severity of disease in acute appendicitis. METHODS: We conducted this retrospective study on appendectomy patients from 1996 to 2001, at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia. We reviewed patient's age, gender, duration of symptoms, temperature on admission, WBC count including differential and the histological diagnosis of the appendicular specimen. We further analyzed the data of those patients found to have acute, gangrenous and perforated appendicitis to determine the correlation between a high WBC count and a more advanced form of appendicitis. RESULTS: Out of an aggregate of 232 patients, 162 were males and 70 females with a mean age of 23.7 years (range, 12-70 years). Mean duration of symptoms was 1.9 +/- 1.1 days, mean temperature 37.8 +/- 1.4 degrees C, with reported elevated WBC count in 167 (71.9%) and normal in 65 (28.1%) cases. Mean WBC counts in acute were 14.5 +/- 7.3 x 10(9)/L, gangrenous 17.1 +/- 3.9 x 10(9)/L and perforated appendicitis 17.9 +/- 2.1 x 10(9)/L. This reflected a persistently higher WBC count in the complex (gangrenous, perforated) appendicitis compared with acute appendicitis (p < 0.05). The differential analysis showed neutrophilia in 123 (53%) and lymphopenia in 112 (48%) cases and out of these, 116 (94%) with neutrophilia and 107 (95%) with lymphopenia were reported to have appendicitis. CONCLUSION: A high WBC with differential count is a reliable indicator of the severity of appendicitis and signifies a more advanced stage.

Acute Disease↗

PubMed2004

Malignant duodenocolic fistula. Various therapeutic surgical modalities.

Malignant duodenocolic fistulas are the most rare and evolutive complication of colonic cancer due to their rapid nutritional disturbances and difficult surgical management. This case report details a 23-year-old female who presented with diarrhea, anorexia, weight loss, anemia and abdominal pain. A series of examinations showed a transverse colon carcinoma with a malignant duodenocolic fistula and direct infiltration of the right lobe of the liver. The patient underwent extended right hemicolectomy with wide local excision of the duodenum and segmental hepatic resection. Postoperative recovery was uneventful. The analysis of other similar cases from the literature treated with this procedure or less frequently, with right hemicolectomy and pancreaticoduodenectomy, allows us to discuss the indications and results of radical surgery. Whenever feasible, resection offers the best treatment as lesser techniques such as bypass and exclusion result only in minimal palliation. The benefit of exploration should almost always be offered, even in such secondary fistulas, as a better quality of life and long term survival are realistic goals and prognostically justifiable.

Adult↗

PubMed2004

Cholesterolosis. Incidence, correlation with serum cholesterol level and the role of laparoscopic cholecystectomy.

OBJECTIVE: To report the incidence of cholesterolosis in the surgically removed gallbladders, its association with serum cholesterol level and to review the role of laparoscopic cholecystectomy in the treatment. METHODS: This retrospective study included all patients who had consecutive cholecystectomies for various gallbladder disorders, performed by 2 consultants during a 5-year period from January 1997 through to December 2002, in the College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. The clinical records of those found to have cholesterolosis on histopathological examination were reviewed, and the data were analyzed for their age, sex, fasting serum cholesterol level and the final outcome of cholecystectomy. RESULTS: The study group was comprised of 549 patients and out of which, 74 (13.4%) had cholesterolosis of the gallbladder. There were 59 (79.9%) female and 15 (20.1%) male patients. Age ranged from 18-64-years with a mean of 35.7-years. Sixty-three (85.1%) cases were reported to have abnormally high fasting serum cholesterol levels (>=5.5 mmol/L), whereas 11 (14.9%) had normal serum cholesterol level. Cholesterolosis with coexistent gallstones was documented in 47 (63.3%) patients while 27 (36.5%) subjects showed acalculous cholesterolosis. Laparoscopic cholecystectomy was performed in 71 (95.9%) individuals, whereas 3 patients ended up with open cholecystectomy (conversion rate of 4.2%). There were no postoperative complications. CONCLUSION: Cholesterolosis of the gallbladder is a distinct pathologic entity and carries a positive correlation with high serum cholesterol level. Laparoscopic cholecystectomy is effective, safe and a feasible treatment modality for cholesterolosis.

Adolescent↗

PubMed2003

Coexistence of multiple anomalies in the celiac-mesenteric arterial system.

The origins and distribution of arteries of the celiac-mesenteric system were examined by dissection of 52 formalin-fixed human cadavers. Seventy-five percent of the cadavers exhibited the classic Michels' Type I hepatolienogastric pattern; 25% had different branching patterns. Multiple anomalies of the celiac-mesenteric arterial system were observed in one Caucasian female cadaver: a short lienogastric trunk; a common hepatic artery arising directly from the abdominal aorta; an anomalous course of the hepatic arteries; an accessory left hepatic artery arising from the left and right gastric arterial anastomosis along the lesser curvature of the stomach; a double cystic artery; a common inferior phrenic trunk arising from the celiac trunk; and an aberrant arterial channel connecting the proximal segments of the splenic and gastroduodenal arteries. A patent ductus venosus and an anomalous formation of the portal vein by the confluence of the splenic and superior and inferior mesenteric veins was also observed. Although single anomalies of the celiac-mesenteric arterial system are common, complex combinations, such as were observed in the present case, represent a significant deviation from the normal developmental pattern. There seems to be no report in the literature of such a combination of anomalies coexisting in one individual. The developmental and clinical significance of these anomalous vessels is discussed.

Abnormalities, Multiple↗

PubMed2003

Extra adrenal retroperitoneal paraganglioma.

We herein report a case of a 45-year-old Saudi lady not diabetic nor hypertensive who presented to the emergency room with a one day history of severe central and lower abdominal pain. On examination, she was hemodynamically stable and abdominal examination showed tenderness in the lower abdomen. Her hematological and biochemical investigations were normal. Computed tomography of the abdomen showed an 8 x 7 cm retroperitoneal mass located at the aortic bifurcation. The patient had exploratory laparotomy and complete excision of the mass. The histopathological study showed a paraganglioma. The patient had an uneventful postoperative period and follow up.

Female↗

PubMed2002

Sternalis. An anatomic variant of chest wall musculature.

OBJECTIVE: To study the prevalence of sternalis muscle in the Kingdom of Saudi Arabia (KSA) and resolve the question of its genesis by studying the innervation of this uncommon variant of anterior chest wall musculature. METHODS: A morphological study of 75 adult cadavers of both sexes was carried out over a 5-year period by macroscopic dissection. We also retrospectively studied the medical records of 1580 adult females who had undergone screening and diagnostic mammographic imaging at King Khalid University Hospital, Riyadh, KSA, from 1997 to 2001. RESULTS: Out of 75 cadavers studied, 3 cases of sternalis muscle were observed. Two adult male cadavers had well developed bilateral sternalis muscles whereas one female cadaver exhibited right sided unilateral sternalis. All 5 sternalis muscles were positioned vertically, in a parasternal position superficial to the medial part of pectoralis major and innervated by branches of intercostal nerves. None of the 1580 women, however, who had undergone mammographic imaging were found to be sternalis positive. CONCLUSION: Consistent with other geographic populations of the world, the frequency of sternalis in KSA is approximately 4%; however, its innervation by the intercostal nerves, as observed in our study is not common. This study highlights the need for familiarity with sternalis, which may mimic a focal density in medial breast craniocaudal mammograms and may be encountered during reconstructive surgery of breast and chest wall.

Female↗