Thyroid cancer in Kuwait: review of 117 cases.

One hundred and seventeen patients with thyroid cancer were seen at the Radiotherapy and Isotope Centre, Al-Sabah Hospital, Kuwait, between 1963 and 1974. Thyroid cancer constituted 4.7 per cent of all cancer cases among females and 2.4 per cent among males. Of these carcinomas, 58 per cent were papillary, 25 per cent follicular, 11 per cent anaplastic and 1.7 per cent medullary. Four cases (3.4 per cent) were of malignant lymphoma. The 10-year survival was 74, 96 and 21 per cent for papillary, follicular and anaplastic tumours respectively. The present series confirms the prognostic value of age, sex and histology and shows that node metastasis does not prejudice survival. The study does not show any correlation between the type of operation and survival.     

Electrical burns in Kuwait: A review and analysis of 64 cases

Sixty-four patients with electrical burns were admitted to the Department of Plastic Surgery, Ibn Sina Hospital, Kuwait during the past 6 years. There were 1202 admissions during this period, the incidence of electrical burns being 5.3 per cent. Sixty-nine per cent of the patients sustained injury from direct contact with live electrical wire, the remaining 31 per cent sustained flash burns. The incidence of low voltage injury was much higher as compared to high voltage. Forty-four per cent of these injuries were not work related. Less than 10 per cent of the body surface area was involved in about 80 per cent of the patients. A total of 65 operations was carried out in 39 patients. Twenty of these patients had repeated debridements until the wound was ready for coverage. All 64 patients survived.     

Renal diseases in Kuwait experience with 244 renal biopsies

The biopsy slides and clinical data on 244 patients who underwent percutaneous renal biopsies in the last 4 years in Kuwait were retrospectively reviewed. The data were analysed to show a correlation between clinical presentation and histological findings. We noted a high incidence of membranoproliferative glomerulonephritis (MPGN) presenting as nephrotic syndrome in association with schistosomal infection, an endemic disease in many of the neighbouring countries. Lupus nephritis was also observed at a relatively increased incidence compared with the West. On the other hand, amyloidosis and IgA nephropathy were less common, 5% for each.     

Postoperative intussusception in adults. A report of 5 cases

Five cases of postoperative intussusception in adults illustrate the clinical features of this uncommon complication. The diagnosis is usually made at laparotomy after a prolonged period of inappropriate conservative treatment, but can be made radiologically if suspected clinically. Simple reduction is usually effective with no potential for recurrence. Although various theories hav e been proposed and various factors implicated, the precise cause and mechanism in individual patients usually remains unknown.     

小儿坏死性肠套叠外科治疗84例分析

目的 探讨小儿坏死性肠套叠的病因、诊断、低压空气灌肠复位的作用、手术治疗及并发症的防治。方法 对经手术治疗的84例小儿坏死性肠套叠进行回顾性分析。结果 本组原发性肠套叠73例,继发性肠套叠11例。套叠类型回-结肠型68例,小肠型12例,结-结肠型4例。全组均行套叠复位加坏死肠段切除一期吻合术。术前误诊5例,死亡3例。结论 ①局部解剖因素是小儿肠套叠发生的主要原因;②B超检查有助于肠套叠的诊断;③对于复发性肠套叠不宜反复多次地进行低压空气灌肠复位;④手术原则是对于高度怀疑肠管坏死的不能姑息,应积极切除,但同时亦应尽可能多地保留有活力的肠管及回盲瓣。     

Intestinal intussusception in adults. Apropos of 8 cases

Traditionally considered the revealing sign of an organic lesion in adults, intestinal intussusception has been reported to be generally idiopathic in African series. The authors analyze 8 cases in adults, of which 6 were idiopathic. Intestinal resection was required in 7 of 8 cases. Mortality was 25%, and linked to intestinal necrosis.     

Management of intussusception in children: A systematic review

ObjectiveThe goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations for the management of ileocolic intussusception in children.MethodsThe ClinicalTrials.gov, Embase, PubMed, and Scopus databases were queried for literature from January 1988 through December 2018. Search terms were designed to address the following topics in intussusception: prophylactic antibiotic use, repeated enema reductions, outpatient management, and use of minimally invasive techniques for children with intussusception. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available evidence.ResultsA total of 83 articles were analyzed and included for review. Prophylactic antibiotic use does not decrease complications after radiologic reduction. Repeated enema reductions may be attempted when clinically appropriate. Patients can be safely observed in the emergency department following enema reduction of ileocolic intussusception, avoiding hospital admission. Laparoscopic reduction is often successful.ConclusionsRegarding intussusception in hemodynamically stable children without critical illness, pre-reduction antibiotics are unnecessary, non-operative outpatient management should be maximized, and minimally invasive techniques may be used to avoid laparotomy.Level of EvidenceLevel 3–5 (mainly level 3–4)Type of studySystematic Review of level 1–4 studies     

The Chiari osteotomy. A review of 58 cases

Fifty-eight Chiari osteotomies performed in 51 patients were reviewed retrospectively. The indications for surgery were painful subluxation, instability, or poor acetabular coverage. The average age at surgery was 16 years (range, 7-45), and the average follow-up period was 40 months. The majority of the patients had congenital hip dislocation, but also included were patients with cerebral palsy, Legg-Calvé-Perthes disease, polio, infection, coxa vara, and epiphyseal dysplasia. Supplemental bone grafts were applied as needed. The functional results were unrelated to age, with 26 excellent, 28 good, and four poorly functional hips. After operation, 39 out of 41 had total pain relief, 41 out of 58 had a normal acetabular index, and 54 out of 58 had a normal center-edge angle. Trendelenburg gaits were unchanged by the Chiari osteotomy, but trochanteric transfer improved the gait in few cases.     

Chondroblastoma. A review of seventy cases

We reviewed the cases of seventy patients with chondroblastoma who were treated at the Istituto Ortopedico Rizzoli between 1949 and 1983 and found that the proximal end of the humerus was the most common location (eighteen), with the proximal end of the femur (fifteen), distal end of the femur (fifteen), and proximal end of the tibia (twelve) being the other frequently involved sites. Sixty-three of the patients were between eleven and thirty years old. Fifty-eight patients sought medical attention because of an aching pain, usually referred to the adjacent joint. Fifty patients were followed for two years or longer after treatment. Seven patients had a local recurrence: four were successfully treated with a repeat curettage and one, by two subsequent marginal excisions; one was advised to have a repeat curettage; and the seventh was advised to have a resection and arthrodesis of the knee. The final functional results were considered to be excellent in forty-seven of the fifty patients who were followed for two years or more.