Background: Patients and physicians are considered primary customers of laboratory services. Therefore, assessing customer satisfaction with laboratory services is an essential indicator in improving the quality of laboratory services. Objectives: This study measures the level of satisfaction of physicians and patients who avail of the clinical laboratory and phlebotomy services, respectively, at the outpatient department (OPD) in King Abdullah Medical City (KAMC), to evaluate the possible issues and carry out corrective actions. Methods: A cross-sectional survey to evaluate the level of satisfaction using a modified patient and physician questionnaires, the patients were randomly selected and interviewed in phlebotomy areas at the outpatient and chemotherapy clinics. A paper-based questionnaires were distributed to all physicians all available physicians in KAMC who were regularly requiring laboratory investigations. The collected data were coded, entered, and checked for outliers or missing data and analyzed using the SPSS statistical package version 21. Results: A total of 435 patients were interviewed and their mean satisfaction was 4.51±0.32 out of 5. Respondents were satisfied with the Availability of laboratory tests. However, they were dissatisfied with Explanation of the phlebotomy cautions by the phlebotomist (75.4%). Twenty eight percent of physicians (132) participated, their mean satisfaction rate was 3.6±0.7 out of 5. The greatest satisfaction rate was related to critical results notification and the communication with laboratory personnel. Physicians were most dissatisfied with both specimen delivery process and incorrect test results. Conclusion: Both customers were satisfied with the laboratory service provided for them. Factors as "Explanation of the phlebotomy process by phlebotomist" and "specimen collection and delivery process" received lowest satisfaction score for patients and physicians respectively. Therefore, improving them is required to meet the needs of the customers and gain their satisfaction regarding the service.
HighlightsA small bowel diverticular disease is uncommon; the incidence is 1–2% of general population.Jejunal diverticula are more common and are larger than those in the ileum.One of very rare complication of small bowel diverticulum was ileal diverticulum with enterocutaneous fistula and abdominal wall abscess.The diverticulum was on the anti-mesenteric border instead of mesenteric border, which may explain the complication with enterocutaneous fistula.Enterolith can develop in the setting of intestinal stasis in the presence of intestinal diverticula.Bowel communication in abdominal wall abscess cases and use imaging modalities, like computed tomography, to optimize the pathway of the management.
Patient: Male, 15 Final Diagnosis: Duodenal pancreatic heterotopia Symptoms: None Medication: — Clinical Procedure: Wedge resection and primary repair Specialty: Surgery Objective: Congenital defects/diseases Background: Heterotopic pancreas is pancreatic tissue that presents outside the normal anatomical location. It is mostly discovered in the upper gastrointestinal tract (mostly the foregut). We report the first case report of incidentaloma of duodenal heterotopic pancreas in obese patients during laparoscopic sleeve gastrectomy. Case Report: A 15-year-old Saudi male obese patient was admitted electively for laparoscopic sleeve gastrectomy. Incidentally, during intraoperative procedure, a duodenal nodule was noted in the first part of the duodenum. A wedge re-section of the mass was done after a standard laparoscopic sleeve gastrectomy was accomplished and it had an uneventful postoperative course. The histopathological examination showed heterotopic pancreas tissue. Conclusions: Gastrointestinal stromal tumors are found to be the most common incidental pathology during bariatric surgery. The safety and efficacy of excision of similar lesions during laparoscopic sleeve gastrectomy needs to be further investigated.
Ameboma is a mass of granulation tissue with peripheral fibrosis and a core of inflammation related to amebic chronic infection. The initial presentations of colonic ameboma usually include obstruction and low gastrointestinal bleeding. It may mimic colon carcinoma or other granulomatous inflammatory conditions of the colon in both the clinical presentation and the endoscopic appearance. Here, we report a case of a 45-year-old male with a presentation of abdominal pain and constipation, as well as clinical, radiological and endoscopic presentation resembling colonic carcinoma, that was managed operatively with right hemicolectomy and post-operative histopathologic finding of cecal ameboma.
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