Rare complication of colonoscopySplenic injury following colonoscopy is rare but can be fatal and easily over looked. 1 The first case was reported in 1974 by Wharry and Zehner. 2 To date 34 cases have been reported, 29 of which appear in an English language publication. 3-33 In most cases, the patient presented within 24 h of the procedure. Delayed presentation is less common but can occur. [6][7][8][9] Colonoscopy is a relatively safe procedure with few complications. The most frequent complications are bleeding after polypectomy 1% and perforation 0.1%. 1 Other less commonly reported complications include pneumothorax, pneumomediestinum, volvulus, hernia incarceration, retroperitoneal abscess and acute appendicitis. [33][34][35][36][37][38] A 73-year-old woman was admitted to the Mater hospital, Newcastle, Australia after colonoscopy for review of her polyps. The patient was well until the next morning when she started to have severe abdominal pain and collapsed in the toilet. Her past medical history included: mastectomy for breast cancer, hysterectomy, open cholecystectomy, partial gastrectomy, hypertension, osteoporosis, pernious anaemia and hip replacement.Colonoscopy was performed under sedation with propofol monitored by staff anaesthetists. Colonoscopy was initially attempted in the left lateral position and subsequently in the supine position as difficulty was encountered while negotiating the colonoscope to the caecum because of looping. Two polyps found in the splenic flexure and transverse colon and were snared. The procedure was tolerated very well and the patient discharged home. Twelve hours later, the patient presented to emergency department with severe abdominal pain, abdominal distension and hypotension.
This paper describes the successful staff engagement strategies underpinning the leadership and continuous transformation journey of the 100% UAE Company AlMansoori whereby a slickline services start-up company in the year 1977 in only one geographical location (Abu Dhabi) transformed into a large conglomerate covering upstream and downstream businesses in oil, gas, chemicals, manufacturing and supporting services.
Rectal lymphoma is a rare condition, presenting in less than 0.5% of all primary rectal neoplasms. Due to the disease’s primary non-specific symptoms, its diagnosis is usually made at advanced stages. Clinically, it is indistinguishable from rectal carcinoma. The optimal approach for managing rectal lymphoma has still not been determined. We report a case of primary rectal diffuse large B-cell lymphoma (stage IV) in a 71-year-old Omani woman.
Background: A chronic wound is one that has failed to proceed through the normal phases of wound healing in an orderly manner. Chronic wounds are a common problem around the world. They can be distressing to the patients causing physical, social and emotional damage such as decreased activities of daily living, pain, discomfort, unpleasant odor, and insomnia. Wellbeing, quality of life and satisfaction of these patients with chronic wounds can be impaired by a complex set of aspects. The purpose of this article is to describe the impact of chronic wounds on the wellbeing, quality of life and satisfaction of Omani patients with chronic wounds. Methods: This is a descriptive cross-sectional study of 275 patients with chronic wounds attending three tertiary care hospitals in Muscat city, Sultanate of Oman. Adult patients of 18 years and above with wounds of duration of more than 4weeks were chosen by consecutive non-probability sampling. A pre-tested, semi-structured self-reported questionnaire was provided to each patient to complete. Data was analysed using SPSS IBM version 23.Results: The average age of the patients was 47.13±16.917 and the majority of them (64.7%) were males. Most of them (29.1%) had diabetic ulcers and 45.8% of them presented with mildly severe wounds based on Bates-Jensen wound assessment scale. Patients with chronic wounds reported a poor wellbeing scores (M=10.47, SD= 1.813), moderate quality of life (M=5.22, SD= 2.388) and satisfaction scores (M=6.89, SD= 2.388). Significant mean differences were reported with age, gender, educational level, and type of wound at p<.05 levels.Conclusion: These findings demonstrated that chronic wounds could influence the wellbeing, quality of life and overall satisfaction with the quality of life of patients suffering with it. These results also suggest a need to pay increased attention by the healthcare providers to the patients suffering from chronic wounds on the aspects of wellbeing and quality of life along with treating the physical symptoms.
Background: Endometriosis of the appendix is reported to be 1 to 3 % of the total endometriosis. Neuromuscular and vascular hamartoma (NMVH) is a rare lesion with only 27 cases reported in intestine since its initial description in 1982 and only one reported case in the appendix until now. We present a 52-year-old Omani female patient complaining of chronic interm Case presentation: itted abdominal pain. On CT scan (computed tomography scan), there was appendiceal lesion near the tip suggestive of mucinous cystadenoma. Diagnostic laparoscopy with appendectomy was conducted. There was a well-dened lesion with central fatty area at appendiceal tip focally merge with the outer muscle layer and mostly embedded in the mesoappendix. Microscopic examination showed focal area of endometriosis at the outer longitudinal muscle layer of the appendix. This focally merge with a well-dened mass like lesion that is embedded in the mesoappendix. The lesion composed of benign random arranged smooth muscle bers, scattered nerve bundles, some of which showed ganglionic cells including degenerated one, adipose tissue, thin and thick-walled small blood vessels. Features were consistent with NMVH that appeared secondary to the nearby endometriosis. Conclusion: Endometriosis of bowel should be suspected in female with longstanding intermitted abdominal pain. NMVH is extremely rare in appendix, thus clinical and radiological suggestion of such diagnosis is difcult. Secondary neuromuscular hamartoma is reported in association with Crohn's disease as a consequence of the chronic inammation and thus could be suspected secondary to endometriosis
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