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Article: Nutcracker Syndrome Accompanying With Superior Mesenteric Artery Syndrome: A Case Report.

Al-Zoubi, Nabil A

Clinical medicine insights. Case reports

2019 Volume 12, Page(s) 1179547619855383

Abstract: Purpose: The duodenum and the left renal vein (LRV) occupy the vascular angle made by the superior mesenteric artery (SMA) and the aorta. When the angle becomes too acute, compression of either structure can occur. Although superior mesenteric artery ... ...

Abstract	Purpose: The duodenum and the left renal vein (LRV) occupy the vascular angle made by the superior mesenteric artery (SMA) and the aorta. When the angle becomes too acute, compression of either structure can occur. Although superior mesenteric artery syndrome (SMAS) and renal Nutcracker syndrome (NCS) share the same pathogenesis, concurrent development has rarely been reported. Case report: A 38-year-old female patient with a past history of gastrojejunostomy operated 6 years ago due to SMAS. She referred to vascular clinic with sever intermittent left-sided loin pain during the last 6 years. Computed tomography (CT)-angiogram and selective LRV angiogram with pressure gradient confirmed the diagnosis of NCS. She was treated by LRV transposition with uneventful recovery and considerable relief of symptoms. Conclusions: NCS accompanying with SMAS is quite unusual. A patient, who first presents with clinical evidence of SMAS, could also simultaneously or sometime thereafter present with NCS and vice versa.
Language	English
Publishing date	2019-06-17
Publishing country	United States
Document type	Case Reports
ZDB-ID	2580498-4
ISSN	1179-5476
ISSN	1179-5476
DOI	10.1177/1179547619855383
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Article ; Online: Idiopathic true aneurysm of distal radial artery: case report.

Al-Zoubi, Nabil A

Vascular health and risk management

2018 Volume 14, Page(s) 279–281

Abstract: Introduction: The incidence rate of true non-traumatic radial artery aneurysms (RAAs) is low, and very few cases have been described. The majority are traumatic in origin and are iatrogenic pseudo-aneurysms following arterial cannulation. However, other ...

Abstract	Introduction: The incidence rate of true non-traumatic radial artery aneurysms (RAAs) is low, and very few cases have been described. The majority are traumatic in origin and are iatrogenic pseudo-aneurysms following arterial cannulation. However, other rare causes such as vascular tumors, connective tissue diseases, and occupational injury have also been reported. Only eight cases were reported as idiopathic true RAA. Herein, I describe a case of true idiopathic distal RAA, which was managed by surgical repair. Case presentation: A 61-year-old-man with no significant medical history presented to vascular clinic with complaint of a nontraumatic mass on the volar aspect and radial side of his right wrist for 6 years. Duplex ultrasound and computed tomography angiogram revealed distal RAA. It was managed by open surgical resection with primary end-to-end anastomosis. Histopathological studies revealed true aneurysm of the distal radial artery. Conclusion: True distal RAAs are an extremely rare entity. Unawareness of this condition might lead to inappropriate management with significant morbidity. Surgical management is generally indicated, but the best treatment remains controversial.
MeSH term(s)	Anastomosis, Surgical ; Aneurysm/diagnostic imaging ; Aneurysm/surgery ; Computed Tomography Angiography ; Humans ; Male ; Middle Aged ; Radial Artery/diagnostic imaging ; Radial Artery/surgery ; Ultrasonography, Doppler, Duplex ; Vascular Surgical Procedures
Language	English
Publishing date	2018-10-11
Publishing country	New Zealand
Document type	Case Reports ; Journal Article
ZDB-ID	2186568-1
ISSN	1178-2048 ; 1176-6344
ISSN (online)	1178-2048
ISSN	1176-6344
DOI	10.2147/VHRM.S182788
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Article ; Online: Spontaneous internal jugular vein thrombosis as primary presentation of antiphospholipid syndrome: case report.

Al-Zoubi, Nabil A

Vascular health and risk management

2018 Volume 14, Page(s) 153–155

Abstract: Introduction: Spontaneous and isolated internal jugular vein (IJV) thrombosis is a rare entity, and atypical localization for venous thromboembolism usually occurs after an oropharyngeal infection, cancer, central venous catheter, and ovarian ... ...

Abstract	Introduction: Spontaneous and isolated internal jugular vein (IJV) thrombosis is a rare entity, and atypical localization for venous thromboembolism usually occurs after an oropharyngeal infection, cancer, central venous catheter, and ovarian hyperstimulation syndrome. This report describes a case of spontaneous IJV thrombosis leading to neck pain and swelling as a primary manifestation of antiphospholipid (Hughes) syndrome. Case presentation: A 44-year-old male with no significant past medical history presented with a 1-week duration of right-sided painful neck swelling. Duplex ultrasound and computed tomography angiogram revealed right IJV thrombosis. Hematology studies were normal apart from positive lupus anticoagulant. The patient was managed conservatively with low molecular weight heparin, antibiotics, and close follow-up. Conclusion: Acute spontaneous IJV thrombosis as a primary presentation of antiphospholipid syndrome is extremely uncommon. We should be aware of the possibility of this condition in the differential diagnosis and management, as long-term anticoagulation is needed.
MeSH term(s)	Adult ; Anti-Bacterial Agents/therapeutic use ; Anticoagulants/therapeutic use ; Antiphospholipid Syndrome/blood ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/diagnosis ; Antiphospholipid Syndrome/drug therapy ; Computed Tomography Angiography ; Humans ; Jugular Veins/diagnostic imaging ; Lupus Coagulation Inhibitor/blood ; Male ; Neck Pain/etiology ; Phlebography/methods ; Ultrasonography, Doppler, Duplex ; Venous Thrombosis/blood ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/drug therapy ; Venous Thrombosis/etiology
Chemical Substances	Anti-Bacterial Agents ; Anticoagulants ; Lupus Coagulation Inhibitor
Language	English
Publishing date	2018-07-16
Publishing country	New Zealand
Document type	Case Reports ; Journal Article
ZDB-ID	2186568-1
ISSN	1178-2048 ; 1176-6344
ISSN (online)	1178-2048
ISSN	1176-6344
DOI	10.2147/VHRM.S170140
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Article: Complications of endo-vascular aortic repair for abdominal aortic aneurysm: A retrospective single-centre experience.

Al-Zoubi, Nabil A / Al-Shawwa, Zuhair

Annals of medicine and surgery (2012)

2021 Volume 64, Page(s) 102219

Abstract: Background: Endovascular aortic repair (EVAR) is obviously less invasive than open aortic repair (OAR) for the treatment of infra-renal abdominal aortic aneurysm (AAA). However, it is not free of complications which can potentially result in severe ... ...

Abstract	Background: Endovascular aortic repair (EVAR) is obviously less invasive than open aortic repair (OAR) for the treatment of infra-renal abdominal aortic aneurysm (AAA). However, it is not free of complications which can potentially result in severe morbidity or even mortality. The purpose of this study was to share our single-center experience with stent-graft related and systemic complications associated with EVAR. Methods: Patients with infra-renal AAA treated by elective and emergency EVAR between March 2014 and November 2020 were retrospectively identified. Demographic data, risk factors, American Society of Anesthesiologists (ASA) score, systemic complications, stent-graft related complications, surgical site complications, 30-day mortality, late EVAR related mortality, estimated blood loss, intensive care unit (ICU) length of stay (LOS), hospital LOS and follow-up durations were collected and analyzed. Results: A total of 43 patients underwent EVAR during the period of study. There were 42 males (97.7%) and 1 female (2.3%). The mean age was 68.8 ± 6.2 years. Elective EVAR was performed in 36 (83.7%) and emergency EVAR in 7 (16.3%). Technical success was achieved in 42 patients (100%) with no conversion to OAR. Stent-graft related complications were (21.0%) endoleaks, (2.3%) graft limb occlusion, (0%) graft infection, and (2.3%) rupture-EVAR. Systemic complications were (2.3%) myocardial infarction (MI), (2.3%) stroke, (2.3%) spinal cord injury (SCI), (2.3%) respiratory failure, (19.0%) wound complications, and (2.3%) acute lower limb ischemia (ALI). The 30-day mortality was (2.3%) due to perioperative MI and the late graft related mortality was (2.3%) due to rupture-EVAR. Conclusion: EVAR showed a high technical success rate with no conversion to OAR. The most common complications were type II and type I endoleaks followed by graft limb occlusion. The 30-day mortality was 2.3% due to perioperative MI. Only one late stent-graft related mortality was registered due to rupture-EVAR.
Language	English
Publishing date	2021-03-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2021.102219
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Article: Chronic Contained Rupture of the Abdominal Aortic Aneurysm.

Al-Zoubi, Nabil A / Mahafdah, Mahmoud R / Albawaih, Omar

Open access emergency medicine : OAEM

2021 Volume 13, Page(s) 439–443

Abstract: Background: The most lethal complication of the abdominal aortic aneurysm (AAA) is rupture (rAAA). A triad of abdominal or back pain, a pulsating mass in the abdomen, and decrease in blood pressure is mostly diagnostic. However, this presentation may ... ...

Abstract	Background: The most lethal complication of the abdominal aortic aneurysm (AAA) is rupture (rAAA). A triad of abdominal or back pain, a pulsating mass in the abdomen, and decrease in blood pressure is mostly diagnostic. However, this presentation may not be complete due to either an impalpable aneurysm or atypical symptoms which leads to difficulties in diagnosis and delayed management. Chronic contained rupture of AAA (CCR-AAA) is a rare but well-recognized condition. Its diagnosis may be difficult because of the atypical and chronic nature of the symptoms. The aim of this study is to investigate the incidence and to highlight the importance of this less common presentation of rAAA. Methods: Patients who presented to King Abdullah University Hospital (KAUH) with infra-renal AAAs (elective and emergency) from January 2014 to April 2021 were prospectively collected. Patients with CCR-AAA were identified and evaluated in terms of demographic data, associated comorbidities, presentation, treatments, and outcomes. Results: A total number of 85 patients were admitted with an infra-renal AAA. Seventeen patients (20.0%) had rAAA, of them only 5 patients (29.4%) were diagnosed with CCR-AAA. CCR-AAAs represent 5.9% of cases with AAA. CCR-AAAs were all in men, with a mean age ± SD of 73.1±8.3. Two patients (40.0%) had abdominal pain, 2 patients (40.0%) had back pain and one patient (10.0%) had no symptoms at the time of diagnosis. Conclusion: CCR-AAA represents 5.9% of all AAA and 29.4% of rAAA. To prevent this potentially fatal condition, awareness is required especially in old males with abdominal or back pain.
Language	English
Publishing date	2021-09-24
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2520704-0
ISSN	1179-1500
ISSN	1179-1500
DOI	10.2147/OAEM.S327922
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Article: Prevalence and Multiplicity of Thrombophilia Genetic Polymorphisms of

Al-Zoubi, Nabil / Alrabadi, Nasr / Kheirallah, Khalid / Alqudah, Ahmad

International journal of general medicine

2021 Volume 14, Page(s) 5323–5332

Abstract: Background: FV: Methods: This cross-sectional study was conducted on randomly selected healthy Jordanian participants. Non-Jordanians and those with a history of arterial/venous thrombosis, atherosclerosis, or a history of recurrent abortions were ... ...

Abstract	Background: FV Methods: This cross-sectional study was conducted on randomly selected healthy Jordanian participants. Non-Jordanians and those with a history of arterial/venous thrombosis, atherosclerosis, or a history of recurrent abortions were excluded from the study. PCR was used to detect variants in DNA extracted from participants' blood samples. Results: A total of 300 subjects were screened: 170 (56.7%) females with an average age of 27.78±9.32 years and 130 (43.3%) males with an average age of 29.88±8.55 years. Genetic variants (at least one) were found in 75% of the subjects (81.2% among females and 66.9% among men), while 64.7%, 52%, and 12% were found to have at least two, three, and four variants, respectively. Overall, 21%, 29%, 54.3%, 27.3%, 7.7%, and 66% of participants were found to have Conclusion: Three-quarters of our population had at least one of the thrombophilia genetic variants, and most had more than one variant. The most common variants detected were associated with
Language	English
Publishing date	2021-09-07
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2452220-X
ISSN	1178-7074
ISSN	1178-7074
DOI	10.2147/IJGM.S324340
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Article ; Online: Nutcracker Syndrome Accompanying With Superior Mesenteric Artery Syndrome

Nabil A Al-Zoubi

Clinical Medicine Insights: Case Reports, Vol

A Case Report

2019 Volume 12

Abstract	Purpose: The duodenum and the left renal vein (LRV) occupy the vascular angle made by the superior mesenteric artery (SMA) and the aorta. When the angle becomes too acute, compression of either structure can occur. Although superior mesenteric artery syndrome (SMAS) and renal Nutcracker syndrome (NCS) share the same pathogenesis, concurrent development has rarely been reported. Case report: A 38-year-old female patient with a past history of gastrojejunostomy operated 6 years ago due to SMAS. She referred to vascular clinic with sever intermittent left-sided loin pain during the last 6 years. Computed tomography (CT)-angiogram and selective LRV angiogram with pressure gradient confirmed the diagnosis of NCS. She was treated by LRV transposition with uneventful recovery and considerable relief of symptoms. Conclusions: NCS accompanying with SMAS is quite unusual. A patient, who first presents with clinical evidence of SMAS, could also simultaneously or sometime thereafter present with NCS and vice versa.
Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
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Article: Gender variation in symptomatic peripheral arterial occlusive disease among type-2 diabetic patients.

Al-Zoubi, Nabil A / Shatnawi, Nawaf J

SAGE open medicine

2019 Volume 7, Page(s) 2050312119840198

Abstract: Purpose: Little is known about the existence of potential gender disparities in peripheral arterial occlusive disease. To our knowledge, this is the first study to analyze differences attributed to gender in type-2 diabetic patients with symptomatic ... ...

Abstract	Purpose: Little is known about the existence of potential gender disparities in peripheral arterial occlusive disease. To our knowledge, this is the first study to analyze differences attributed to gender in type-2 diabetic patients with symptomatic peripheral arterial occlusive disease, with regard to clinical presentations, risk factors and anatomical distributions of atherosclerosis. Patients and methods: This study was conducted at King Abdullah University Hospital, Jordan. Medical records of all diabetic (type-2) patients who presented with symptomatic peripheral arterial occlusive disease in the period from January 2012 and November 2017 were reviewed, data were collected retrospectively. In all, 364 patients (282 males and 82 females) were involved. Criteria for diagnosis include the following Ankle-Brachial Index ⩽ 0.9 and intermittent claudication or critical limb ischemia. Risk factors for atherosclerosis (age, smoking and hypertension) and computed tomography-angiogram findings were analyzed using Statistical Package for the Social Sciences. p < 0.05 was considered statistically significant. Results: The mean age was higher in females than males (67.61 vs 62.61 years; p = 0.001). Females had greater prevalence of uncontrolled diabetes compared to males (HbA1c 9.07 in females vs 8.51 in males; p = 0.03). High density lipoprotein was higher in females than males (1.02 vs 0.935; p = 0.009). Females presented more with critical limb ischemia than intermittent claudication in comparison with males (p = 0.017). Involvement of superficial femoral artery, deep femoral artery and peroneal artery in hemodynamic relevant atherosclerotic lesion was significantly higher in females than males (p < 0.05). However, involvement of common iliac artery with hemodynamic relevant atherosclerotic lesion was significantly higher in males than females (p = 0.003). Conclusions: Clinical presentation, risk factors and anatomical distributions of atherosclerosis among type-2 diabetic patients with symptomatic peripheral arterial occlusive disease are different between males and females. When compared to males, female patients presented more with critical limb ischemia than intermittent claudication. Females showed higher age at presentation, poor control of diabetes mellitus and higher level of high density lipoprotein. Involvement of superficial femoral artery, deep femoral artery and peroneal artery in hemodynamic relevant atherosclerotic lesion were significantly higher in females than males. In contrast, common iliac artery involvement with hemodynamic relevant atherosclerotic lesion was significantly higher in males than females.
Language	English
Publishing date	2019-04-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2735399-0
ISSN	2050-3121
ISSN	2050-3121
DOI	10.1177/2050312119840198
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Article ; Online: Nonhealing Leg Ulcer as the Presentation of Sarcoidosis: A Case Report.

Shatnawi, Nawaf J / Al-Zoubi, Nabil A / Al-Bakkar, Lujain A / Gharaibeh, Laith M / Hamouri, Shadi

The international journal of lower extremity wounds

2021 Volume 22, Issue 4, Page(s) 742–747

Abstract: Chronic leg ulcers (CLUs) are common, with increasing prevalence in the elderly population. Circulatory dysfunctions are responsible for 90% to 95% of all causes, while 5% to 10% of CLUs are associated with underlying chronic systemic disorders. ... ...

Abstract	Chronic leg ulcers (CLUs) are common, with increasing prevalence in the elderly population. Circulatory dysfunctions are responsible for 90% to 95% of all causes, while 5% to 10% of CLUs are associated with underlying chronic systemic disorders. Sarcoidosis is a complex multisystemic disease characterized by noncaseating granulomas affecting mainly the pulmonary system, with cutaneous manifestation in 25% to 30% of cases. However, ulcerative sarcoidosis (US) is a rare form of cutaneous sarcoidosis. Pyoderma gangrenosum (PG) is an uncommon, chronic inflammatory noninfectious skin disease affecting different body parts. The ulcerative form of PG is rarely reported in association with sarcoidosis.We aim to report a 44-year-old female patient with a history of hypertension and varicose veins, presenting with a CLU for more than 18 months. Ulcer tissue biopsy showed noncaseating granuloma with abscess formation suggestive of sarcoidosis; however, PG could not be ruled out. Mediastinal lymph node biopsy was consistent with sarcoidosis. The leg ulcer had complete healing within 4 months by local wound management, negative pressure wound therapy, and split-thickness skin grafting without immunosuppressive treatment to achieve wound healing.
MeSH term(s)	Adult ; Female ; Humans ; Immunosuppressive Agents ; Leg/pathology ; Leg Ulcer/therapy ; Pyoderma Gangrenosum/pathology ; Sarcoidosis/complications ; Sarcoidosis/pathology ; Skin/pathology
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2021-08-10
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2171119-7
ISSN	1552-6941 ; 1534-7346
ISSN (online)	1552-6941
ISSN	1534-7346
DOI	10.1177/15347346211037850
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Article: The impact of COVID-19 on the surgical operations.

Mazahreh, Tagleb S / Aleshawi, Abdelwahab J / Al-Zoubi, Nabil A / Hatamleh, Moad / Hmedat, Alaa

Annals of medicine and surgery (2012)

2020 Volume 57, Page(s) 49–51

Keywords	covid19
Language	English
Publishing date	2020-07-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2020.06.042
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