RESUMO
Background: Candy cane syndrome (CCS) is a rare and underreported complication, seldom occurring after bariatric surgeries, especially, the Roux-en-Y gastric bypass (RYGB) type. It refers to an excessively long-blind end of the alimentary limb, usually at the gastrojejunal (GJ) junction, and to a lesser extent, can occur at the jejunojejunal (JJ) junction, that may cause symptoms including abdominal pain, regurgitation, nausea, vomiting and reflux. However, its diagnosis can be challenging and misleading. Case Description: A 34-year-old woman with a multiple past surgical history presented with small bowel obstruction (SBO) symptoms following a second gastric bypass surgery. An esophagogastroduodenoscopy (EGD) was inconclusive, then a computed tomography (CT) scan was done, which reported intussusception. The patient underwent laparoscopy, which revealed an anastomosis with an extra 14 cm of single-loop bowel near the JJ junction rather than intussusception, leading to a diagnostic laparoscopy followed by a mini-laparotomy procedure. Adhesiolysis followed by a resection of the elongated blind end was done, hence, the diagnosis of CCS was established. The patient tolerated the surgery with a complete resolution of her symptoms; no subsequent complications were reported. Conclusions: The frequency of RYGB surgery and the number of past surgeries a patient might have undergone might correlate independently with the risk of developing CCS.
RESUMO
Angina bullosa hemorrhagica (ABH) is a rare, benign condition that is characterized by a blood-filled blister in the oropharynx. This report describes the case of a 27-year-old male who developed a blister in the oral cavity that ruptured abruptly and resolved spontaneously. The diagnosis of ABH was made according to the diagnostic criteria of Ordioni et al. The core motive of this report is to demonstrate the clinical features and course of ABH to avoid misdiagnosis.
RESUMO
Background: Limited attention is devoted to the improvement of the quality of life of patients suffering from the negative consequences of Sickle cell disease (SCD). Our study focuses on the evaluation of the performance of the WHOQOL-BREF as a tool to measure the quality of life of SCD Patients in Bahrain. Methods: We conducted a cross-sectional study that enrolled 273 SCD patients selected using a simple random sampling technique from primary health-care centers in Bahrain in 2019. A designed questionnaire including the WHOQOL-BREF was filled by the patients in the health centers. The reliability of the WHOQOL-BREF was assessed by standardized Cronbach's alpha coefficient, and the validity was measured by convergent validity, principal component analysis and confirmatory factor analysis. Results: The WHOQOL-BREF had good internal consistency as Cronbach's alpha coefficient for the overall scale was 0.91. The convergent validity results indicated that the correlation coefficients values for all scale domains are significantly correlated at α < 0.01. Confirmatory factor analysis found that the four-domain structure produced a robust fit to the data. Conclusion: The WHOQOL-BREF tool has high internal consistency and validity in assessing the quality of life of Sickle Disease patients in Bahrain.
