Jejunal Gastrointestinal Stromal Tumor and Gallstones.

Gastrointestinal stromal tumors (GISTs) are considered the most common mesenchymal tumors of the digestive system. However, they make up less than 1% of all GI tumors. GISTs arise from the interstitial cells of Cajal and are commonly found in the stomach and small intestine, and rarely in the colon and esophagus. In this case report, we present a 57-year-old male, a known diabetic, who complained of abdominal pain. He was diagnosed with cholelithiasis and a GIST in the jejunum, which was managed laparoscopically without complications. Most of the time, patients with GIST present with vague symptoms, or sometimes, they are asymptomatic. The most common symptoms are abdominal pain, GI bleeding, and an abdominal mass. These symptoms are usually related to the site of tumor growth, tumor size, and tumor rupture or perforation. Regardless of the tumor location, surgical excision is the gold standard for treating GISTs.

Mucocele of the Appendix: A Case Report and Review of Literature.

An appendiceal mucocele is a rare disease characterized by the dilation of the appendix lumen with mucus accumulation. Although this disease is often found incidentally during appendectomy, it is crucial to differentiate it from acute appendicitis preoperatively to select adequate surgical management. We present a case of a 31-year-old male, medically free, with right-sided abdominal pain associated with nausea and vomiting. He was diagnosed with appendiceal mucocele and underwent laparoscopic appendectomy. The absence of a distinct clinical presentation and biochemical parameters necessitates a comprehensive and collaborative diagnostic approach for mucocele of the appendix. Achieving an accurate diagnosis prior to surgery is imperative to ensure the appropriate surgical technique is chosen, thereby minimizing the risk of serious intraoperative and postoperative complications such as pseudomyxoma peritonei.

Successful Conservative Management of Spontaneous Greater Omental Artery Aneurysm: A Case Report.

Omental hemorrhage is the result of a rupture of the omental vessels. Many causes have been identified to cause omental hemorrhage, which includes trauma, aneurysms, vasculitis, and neoplasms. Spontaneous omental hemorrhage is rare, and usually, patients present with a vague clinical manifestation. In this article, we present the case of a 62-year-old male patient who presented to the emergency department complaining of severe epigastric pain. He was diagnosed by enhanced computed tomography as having a great omental aneurysm and admitted to the surgical ward. The patient was treated conservatively with no apparent complications. Physicians should be made aware of the possibility of great omental bleeding even if none of the mentioned risk factors have been recognized to prevent the life-threatening complications that would follow this condition.

Successful Management of a Young Patient Suffering From Pyoderma Gangrenosum Following Gastric Bypass Surgery: A Case Report.

Pyoderma gangrenosum (PG) is a pathogenetically ill-defined neutrophilic dermatosis frequently characterized by severely painful ulcerations with no identifiable infective pathogens. There are no diagnostic criteria for PG, nor specific gold standard management, which may complicate the process of dealing with patients suffering from this disease. Here, we report a case of a 27-year-old male patient, with a history of gastric bypass surgery three years ago, who presented with a left leg non-healing ulcer diagnosed as a PG by the clinical presentation and biopsy of the ulcer. He was managed by the administration of systemic immunomodulators, a surgical debridement procedure, and the application of a vacuum. The patient was discharged with vitamin B complex and vitamin D supplements as well as zinc sulfate and folic acid. Also, multiple doses of Infliximab intravenously and vitamin B 12 intramuscularly result in a satisfactory healing process of the ulcer. Since PG is a diagnosis of exclusion, clinicians must be aware of the need for highly specific history-taking, previous surgical history, laboratory investigations, and histopathological workup in order to reach the diagnosis.

Successful Conservative Management of Traumatic Pancreatic Duct Injury: A Case Report.

Patients with blunt abdominal trauma are at high risk of getting pancreatic injury, with high morbidity and mortality rates. The decision to manage the patient operatively depends highly on the condition of the main pancreatic duct (MPD). Conservative management of traumatic MPD injuries is rarely reported in the literature. In this article, we present the case of a 19-year-old male patient, medically free, admitted to the hospital following blunt abdominal trauma. He was hemodynamically stable and computed tomography showed MPD injury with no evidence of active bleeding or bile leakage. So, the decision to manage him conservatively was taken. Our aim in this report is to highlight the fact that the operative management of traumatic MPD injuries, which carries dangerous post-operative complications, could be avoided.

Risk Assessment of Varicose Veins Among Teachers in Al-Ahsa, Saudi Arabia.

Background Varicose veins (VV) are abnormally swollen, tortuous, and prominent veins caused by insufficient venous valves leading to venous congestion and elevated venous pressure. Prolonged standing at work has been proposed to be an important risk factor for varicose veins. Teachers are prone to have varicose veins due to prolonged standing. The aim of this study was to assess the risk of varicose veins among teachers in Al-Asha, Saudi Arabia. Method This was a cross-sectional study conducted among teachers of primary, secondary, and high schools in Al-Ahsa, of both genders, between April 2022 and June 2022. The participants were interviewed and examined for the presence of signs and symptoms of the disease. Finally, the collected data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, version 26.0 for Windows) software. Result Out of 399 participating teachers with a mean age of 43.2 ± 12.9 years, 216 (54.1%) were males and the remainder were female. The commonest symptom was pain in the legs, which was exacerbated by work (43.1%). Most of the participants were working for more than 16 years (43.6%) and standing for less than six hours per day (72.7%). The most pointed sign was spider legs-shaped veins (23.8%). However, the least collective sign was paleness in the ulcer area after healing (1.8%). A total of 140 teachers had a family history of varicose veins, 74 of them (18.5%) were diagnosed with varicose veins previously. We summarize our result as female teachers who have a family history of VV have more risk to develop the disease. Conclusion The prevalence of varicose veins was high among teachers in Al-Ahsa, Saudi Arabia. According to our study, teachers have a significant chance of developing the condition since their working style contributes to its progression. Further actions need to be made in order to increase awareness and prevent its complications.

Solid Ectopic Cervical Thymus: A Case Report.

The thymus gland is a lymphoid organ normally located in the superior anterior mediastinum. It can rarely present abnormally in other sites along the thymopharyngeal canal and it might cause difficulties in breathing and/or feeding. We present a case report of an ectopic cervical thymus of a 10-month-old male infant who was presented to the hospital with a swelling on the left side of his neck for nine months. Investigations raised suspicion about four differential diagnoses and a total surgical excision for histopathological confirmation was deemed mandatory. It is of great importance to consider ectopic cervical thymus in the differential diagnosis of pediatric neck masses to avoid unnecessary procedures and prevent possible complications.

The Side Effects of COVID-19 Vaccines and Its Association With ABO Blood Type Among the General Surgeons in Saudi Arabia.

Introduction The benefits of vaccination outweigh its risks as it protects approximately two to three million individuals from infectious diseases annually. With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, new vaccines have been developed. However, it is crucial to follow and recognize the side effects of COVID-19 vaccines. Previous studies have shown a relationship between ABO blood groups and coronavirus. Some vaccination side effects, such as muscle pain at the injection site and fatigue, may impair an individual's ability to perform tasks that require fine motor skills, such as those performed by a general surgeon. Therefore, this study aimed to identify the association between ABO blood groups and the side effects of COVID-19 vaccines among general surgeons in Saudi Arabia. Method A cross-sectional online survey-based study regarding the side effects following COVID-19 vaccination was conducted among Saudi and non-Saudi general surgeons working in public and private hospitals in Saudi Arabia who had received one or two doses of mRNA-based COVID-19 vaccines. Results A total of 612 surgeons responded. Approximately, 74.7% of the respondents reported side effects after receiving vaccines. Tiredness was the most commonly reported side effect of the vaccine, followed by severe local pain at the site of injection. Approximately, 16.2% of the participants started showing side effects 12 hours after receiving the vaccine. There was a significant relationship between the type of vaccine administered and the appearance of side effects (p = 0.004). The rate of appearance of side effects was higher in participants who received the Pfizer vaccine. However, there was no significant relationship between the appearance of side effects and age, gender, blood group, number of doses, and past history of COVID-19 infection (p > 0.05). Of the total participants, 256 (41.8%) stated that the side effects of the vaccine affected their work performance. Moreover, there was no significant difference in side effects, symptoms appearing after vaccination, the onset of symptoms, and duration of symptoms between the participants who received one dose and those who received two doses of the vaccine. In addition, there was no significant relationship between the severity of side effects and age, past history of COVID-19 infection, number of doses, and blood type (p > 0.05). However, there was a significant relationship between the severity of side effects and gender and type of vaccine (p = 0.000 and 0.004, respectively). A high percentage of females and those who received the AstraZeneca vaccine stated that their side effects affected their work performance. Conclusion Three-quarters of the participants reported side effects after the COVID-19 vaccination, which affected the work performance of 41% of participating general surgeons. There was no significant relationship between the appearance of symptoms and age, gender, blood group, number of doses, and past history of COVID-19 infection. However, there was a significant relationship between the severity of side effects and gender and type of vaccination. Future large-scale studies are recommended to further evaluate the implication of ABO blood type on COVID-19.

Gastric Perforation as a Complication of COVID-19 Infection: A Case Report.

Pulmonary symptoms are the primary manifestation of the COVID-19 disease, which originated in Wuhan in China in December 2019. However, it is now established to show widespread extrapulmonary manifestations, including gastrointestinal involvement. Abdominal pain, diarrhea, nausea, and vomiting are considered the most common gastrointestinal symptoms. Gastric perforation in association with COVID-19 is rarely reported in the literature. Here, we report a case of a 71-year-old male COVID-19-infected patient, medically free, who presented to the emergency department complaining of severe abdominal pain for a one-week duration. He was diagnosed with a case of perforated viscus and septic shock. The patient was shifted to the operating room for exploratory laparotomy. We aim in this report to highlight this fatal complication of COVID-19 infection in order to improve patients' outcomes.

Giant Breast Lipoma: A Case Report.

Lipomas are slow-growing, benign mesenchymal masses. Most lipomas are small, weighing only a few grams; however, if their size becomes exceptionally large, they are called giant lipomas. Giant lipoma of the breast is infrequently observed due to the rarity of size and location, with very few case reports available in the literature. Here, we report the case of a 48-year-old female patient who presented with a painless, huge lump in her right breast. The patient underwent surgical removal of the mass with a histologic examination confirming the diagnosis of a giant breast lipoma.

Appendiceal Adhesion to the Gallbladder Detected During Laparoscopic Cholecystectomy: A Case Report.

Acute cholecystitis is a very common acute abdominal disease that mostly indicates abdominal surgery. Appendiceal adhesion to the gallbladder is a very rare condition detected during laparoscopic surgery. A 54-year-old female patient, with a known case of diabetes and hypertension, presented with right upper quadrant abdominal pain of four months' duration. The pain was increasing in severity and associated with fatty meals. She was diagnosed with acute cholecystitis and was sent to the operating room for laparoscopic cholecystectomy. Appendiceal adhesion to the gallbladder was found, and laparoscopic cholecystectomy and laparoscopic appendectomy were performed. Adhesion of the appendix to the gallbladder should be considered by general surgeons.