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  1. Article ; Online: Predictors of marginal ulcer after gastric bypass: a systematic review and meta-analysis.

    Beran, Azizullah / Shaear, Mohammad / Al-Mudares, Saif / Sharma, Ishna / Matar, Reem / Al-Haddad, Mohammad / Salame, Marita / Portela, Ray / Clapp, Benjamin / Dayyeh, Barham K Abu / Ghanem, Omar M

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

    2023  Volume 27, Issue 6, Page(s) 1066–1077

    Abstract: Introduction: Marginal ulcer (MU) is a common complication following Roux-en-Y gastric bypass (RYGB) with an incidence rate of up to 25%. Several studies have evaluated different risk factors associated with MU with inconsistent findings. In this meta- ... ...

    Abstract Introduction: Marginal ulcer (MU) is a common complication following Roux-en-Y gastric bypass (RYGB) with an incidence rate of up to 25%. Several studies have evaluated different risk factors associated with MU with inconsistent findings. In this meta-analysis, we aimed to identify the predictors of MU after RYGB.
    Methods: A comprehensive literature search of PubMed, Embase, and Web of Science databases was conducted through April 2022. All studies that used a multivariate model to assess risk factors for MU after RYGB were included. Pooled odds ratios (OR) with 95% confidence intervals (CI) for risk factors reported in ≥ 3 studies were obtained within a random-effects model.
    Results: Fourteen studies with 344,829 patients who underwent RYGB were included. Eleven different risk factors were analyzed. Meta-analysis demonstrated that Helicobacter pylori (HP) infection (OR 4.97 [2.24-10.99]), smoking (OR 2.50 [1.76-3.54]), and diabetes mellitus (OR 1.80 [1.15-2.80]), were significant predictors of MU. Increased age, body mass index, female gender, obstructive sleep apnea, hypertension, and alcohol use were not predictors of MU. There was a trend of an increased risk of MU associated with nonsteroidal anti-inflammatory drugs (OR 2.43 [0.72-8.21]) and a lower risk of MU with proton pump inhibitors use (OR 0.44 [0.11-2.11]).
    Conclusions: Smoking cessation, optimizing glycemic control, and eradication of HP infection reduce the risk of MU following RYGB. Recognition of predictors of MU after RYGB will allow physicians to identify high-risk patients, improve surgical outcomes, and reduce the risk of MU.
    MeSH term(s) Humans ; Female ; Gastric Bypass/adverse effects ; Peptic Ulcer/etiology ; Peptic Ulcer/surgery ; Risk Factors ; Proton Pump Inhibitors ; Hypertension/complications ; Obesity, Morbid/surgery ; Obesity, Morbid/complications ; Retrospective Studies
    Chemical Substances Proton Pump Inhibitors
    Language English
    Publishing date 2023-02-16
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1007/s11605-023-05619-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Appendicitis Secondary to Trauma following a Camel Kick: Case Report and Review of Literature.

    Toffaha, Ali / Al-Yahri, Omer / Hijawi, Zainab / Al-Mudares, Saif / Al-Tarakji, Mohannad / Shahid, Fakhar / Ali, Syed Muhammad

    Case reports in surgery

    2021  Volume 2021, Page(s) 6667873

    Abstract: Introduction: Independently, trauma and appendicitis are two of the most common conditions in surgical practice. Rarely, both conditions may coexist, which raises the controversy whether it is merely a coincidence or trauma may lead to acute ... ...

    Abstract Introduction: Independently, trauma and appendicitis are two of the most common conditions in surgical practice. Rarely, both conditions may coexist, which raises the controversy whether it is merely a coincidence or trauma may lead to acute appendicitis.
    Conclusions: Blunt abdominal trauma caused by a camel kick to the abdomen requires a close observation of the patients. A camel kick may increase intra-abdominal pressure and cause internal organ injury including the appendix. Therefore, acute appendicitis should be considered in differential diagnosis in any patient with abdominal pain resembling appendicitis following blunt abdominal trauma.
    Language English
    Publishing date 2021-01-07
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2657697-1
    ISSN 2090-6919 ; 2090-6900
    ISSN (online) 2090-6919
    ISSN 2090-6900
    DOI 10.1155/2021/6667873
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Strangulated Internal Hernia through Appendicular Tourniquet/Ring: Unusual Cause of Intestinal Obstruction.

    Ali, Syed Muhammad / Khalil, Ibrahim Adnan / Musthafa, Shameel / Shah, Amjad Ali / Aftab, Zia / Al-Mudares, Saif

    The American journal of case reports

    2020  Volume 21, Page(s) e920384

    Abstract: BACKGROUND Intestinal obstruction secondary to internal hernia is a rare phenomenon in adults particularly in patients with history of pulmonary tuberculosis, but commonly seen in pediatric population. Mostly it occurs along the duodenum in the ... ...

    Abstract BACKGROUND Intestinal obstruction secondary to internal hernia is a rare phenomenon in adults particularly in patients with history of pulmonary tuberculosis, but commonly seen in pediatric population. Mostly it occurs along the duodenum in the paraduodenal recesses. The patient might be misdiagnosed as having obstruction secondary to strictures formed as a result of intestinal tuberculosis and pose delay in exploration. CASE REPORT We describe an adult patient who presented with intestinal obstruction by a tourniquet or ring formed between the tip of appendix and ileocecal junction through which small bowel herniated, strangulated and finally perforated before exploration, initially thought to be due to intestinal tuberculosis. He underwent exploratory laparotomy and was release of obstruction, appendectomy and resection of bowel. The patient tolerated the procedure well and discharged in stable condition. CONCLUSIONS Intestinal obstruction due to internal hernia is rare in adults. Computed tomography abdomen can diagnose the condition; however, exploration of the abdomen can give the definite diagnosis and tailor the appropriate therapy.
    MeSH term(s) Appendectomy ; Appendix/abnormalities ; Appendix/surgery ; Constriction, Pathologic ; Hernia/complications ; Herniorrhaphy ; Humans ; Ileum/surgery ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery ; Laparotomy ; Male ; Young Adult
    Language English
    Publishing date 2020-02-14
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.920384
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Platelet to Lymphocyte Ratio Associated with Prolonged Hospital Length of Stay Postpeptic Ulcer Perforation Repair: An Observational Descriptive Analysis.

    Al-Yahri, Omer / Saafan, Tamer / Abdelrahman, Husham / Aleter, Ammar / Toffaha, Ali / Hajjar, Mustafa / Aljohary, Hesham / Alfkey, Rashad / Zarour, Ahmad / Al-Mudares, Saif / El-Menyar, Ayman

    BioMed research international

    2021  Volume 2021, Page(s) 6680414

    Abstract: Background: The predictive role of platelet to lymphocyte ratio (P/LR) in patients with perforated peptic ulcer (PPU) is not well-studied. We aimed to investigate the association between the P/LR ratio and the hospital length of stay (HLOS) for ... ...

    Abstract Background: The predictive role of platelet to lymphocyte ratio (P/LR) in patients with perforated peptic ulcer (PPU) is not well-studied. We aimed to investigate the association between the P/LR ratio and the hospital length of stay (HLOS) for surgically treated PPU.
    Method: This is a retrospective observational study for surgically treated adult cases of PPU at Hamad Medical Corporation during the period from January 2012 to August 2017. Patients were categorized into two groups based on their HLOS (I week). The receiver operating characteristic (ROC) curve was plotted to determine the cutoff value for lymphocyte count, neutrophil to lymphocyte ratio, and P/LR ratio for predicting the prolonged hospitalization.
    Results: One hundred and fifty-two patients were included in the study. The majority were young males. The mean age was 38.3 ± 12.7 years. Perforated duodenal ulcer (139 patients) exceeded perforated gastric ulcer (13 patients). The HLOS > 1 week was observed in 14.5% of cases. Older age (
    Conclusion: High preoperative P/LR value predicts prolonged HLOS in patients with repaired perforated peptic ulcer. Further larger multicenter studies are needed to support the study findings.
    MeSH term(s) Adult ; Duodenal Ulcer/blood ; Duodenal Ulcer/surgery ; Female ; Humans ; Length of Stay ; Lymphocyte Count ; Male ; Middle Aged ; Peptic Ulcer Perforation/blood ; Peptic Ulcer Perforation/surgery ; Platelet Count ; Retrospective Studies
    Language English
    Publishing date 2021-03-09
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Observational Study
    ZDB-ID 2698540-8
    ISSN 2314-6141 ; 2314-6133
    ISSN (online) 2314-6141
    ISSN 2314-6133
    DOI 10.1155/2021/6680414
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: An Unusual Presentation of Gallstone Ileus: A Red-Herring or Missed Diagnosis.

    Al-Mudares, Saif / Kurer, Mohamed / Koshy, Renol M / El-Menyar, Ayman

    The American journal of case reports

    2016  Volume 17, Page(s) 301–304

    Abstract: Background: Gallstone ileus is a rare complication of chronic calcular cholecystitis and an uncommon etiological entity responsible for mechanical intestinal obstruction. The most common obstructed part is the narrow terminal ileum, whereas the jejunum ... ...

    Abstract Background: Gallstone ileus is a rare complication of chronic calcular cholecystitis and an uncommon etiological entity responsible for mechanical intestinal obstruction. The most common obstructed part is the narrow terminal ileum, whereas the jejunum is rarely affected. The gallstone is postulated to reach the small bowel by gradual erosion from the gall bladder, most commonly into the duodenum, forming a cholecysto-duodenal fistula.
    Case report: Herein, we report a 72-year-old male who presented with intestinal obstruction of a 5-day duration, with a clinical diagnosis of an irreducible inguinal hernia. However, the patient continued to be symptomatic following an uncomplicated hernioplasty. A computerized tomography (CT) scan of the abdomen revealed a small bowel lesion, which intra-operatively was confirmed to be an impacted gallstone in the jejunum with a cholecysto-duodenal fistula.
    Conclusions: Despite gallstone is uncommon cause of intestinal obstruction, a high index of suspicion with a careful CT scan interpretation is the key to the diagnosis, especially when there is a red-herring distracting the attention, like irreducible hernia in this case.
    MeSH term(s) Aged ; Biliary Fistula/complications ; Gallstones/complications ; Gallstones/diagnosis ; Humans ; Ileus/diagnosis ; Ileus/etiology ; Intestinal Fistula/complications ; Intestinal Obstruction/etiology ; Jejunal Diseases/diagnosis ; Jejunal Diseases/etiology ; Male
    Language English
    Publishing date 2016-05-02
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/ajcr.897646
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Giant cavernous liver hemangiomas: is it the time to change the size categories?

    Di Carlo, Isidoro / Koshy, Renol / Al Mudares, Saif / Ardiri, Annalisa / Bertino, Gaetano / Toro, Adriana

    Hepatobiliary & pancreatic diseases international : HBPD INT

    2016  Volume 15, Issue 1, Page(s) 21–29

    Abstract: Background: Four different sizes (4, 5, 8 and 10 cm in diameter) can be found in the literature to categorize a liver hemangioma as giant. The present review aims to clarify the appropriateness of the size category "giant" for liver hemangioma.: Data ... ...

    Abstract Background: Four different sizes (4, 5, 8 and 10 cm in diameter) can be found in the literature to categorize a liver hemangioma as giant. The present review aims to clarify the appropriateness of the size category "giant" for liver hemangioma.
    Data sources: We reviewed the reports on the categorization of hemangioma published between 1970 and 2014. The number of hemangiomas, size criteria, mean and range of hemangioma sizes, and number of asymptomatic and symptomatic patients were investigated in patients aged over 18 years. Liver hemangiomas were divided into four groups: <5.0 cm, 5.0-9.9 cm, 10.0-14.9 cm and ≥15.0 cm in diameter. Inclusion criteria were noted in 34 articles involving 1972 (43.0%) hemangiomas (>4.0 cm).
    Results: The patients were divided into the following groups: 154 patients (30.0%) with hemangiomas less than 5.0 cm in diameter (small), 182 (35.5%) between 5.0 cm and 9.9 cm (large), 75 (14.6%) between 10.0 and 14.9 cm (giant), and 102 (19.9%) more than 15.0 cm (enormous). There were 786 (39.9%) asymptomatic patients and 791 (40.1%) symptomatic patients. Indications for surgery related to symptoms were reported in only 75 (3.8%) patients. Operations including 137 non-anatomical resection (12.9%) and 469 enucleation (44.1%) were unclearly related to size and symptoms.
    Conclusions: The term "giant" seems to be justified for liver hemangiomas with a diameter of 10 cm. Hemangiomas categorized as "giant" are not indicated for surgery. Surgery should be performed only when other symptoms are apparent.
    MeSH term(s) Hemangioma, Cavernous/classification ; Hemangioma, Cavernous/complications ; Hemangioma, Cavernous/pathology ; Hemangioma, Cavernous/surgery ; Hepatectomy ; Humans ; Liver Neoplasms/classification ; Liver Neoplasms/complications ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Predictive Value of Tests ; Risk Factors ; Terminology as Topic ; Tumor Burden
    Language English
    Publishing date 2016-01-27
    Publishing country Singapore
    Document type Journal Article ; Review
    ZDB-ID 2241386-8
    ISSN 1499-3872
    ISSN 1499-3872
    DOI 10.1016/s1499-3872(15)60035-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Intraoperative diagnosis of solitary cecal diverticulum not requiring surgery: is appendectomy indicated?

    Koshy, Renol M / Abusabeib, Abdelrahman / Al-Mudares, Saif / Khairat, Mohamed / Toro, Adriana / Di Carlo, Isidoro

    World journal of emergency surgery : WJES

    2016  Volume 11, Page(s) 1

    Abstract: Aim: To compare experience with solitary cecal diverticulum (SCD) with literature on the indication for appendectomy in cases of solitary cecal diverticulitis.: Methods: We retrospectively reviewed all cases of SCD in our institution from September ... ...

    Abstract Aim: To compare experience with solitary cecal diverticulum (SCD) with literature on the indication for appendectomy in cases of solitary cecal diverticulitis.
    Methods: We retrospectively reviewed all cases of SCD in our institution from September 2011 to March 2013. Data on sex, age, ethnic origin, presence of pain in the right iliac fossa, duration of symptoms, diagnosis, management, intraoperative findings, histologic examination, hospital stay, complications, and follow-up were reviewed and analyzed. We compared this to related literature reported between 2000 and 2015.
    Results: In the study period, 10 patients presented with an SCD. Male sex and Asian origin were predominant. All patients had pain in the right iliac fossa, with a duration of 2-5 days. In nine cases the diagnosis was made by clinical examination and laboratory testing. One patient who had undergone a previous appendectomy was diagnosed with SCD by computed tomography. This last patient was treated conservatively, four patients were treated with resection of the cecum "en bloc" with the last jejunal loop and appendix, and the other five patients were treated with appendectomies. Two patients had minor complications. All patients were followed up for a minimum of 12 to a maximum of 24 months. No recurrence was recorded in either the case treated conservatively or the cases treated by appendectomies.
    Conclusions: In cases of operative but conservative treatment for SCD, appendectomy could be justified to avoid misdiagnosis in case of future episodes of solitary cecal diverticulitis.
    Language English
    Publishing date 2016
    Publishing country England
    Document type Journal Article ; Review
    ISSN 1749-7922
    ISSN 1749-7922
    DOI 10.1186/s13017-015-0057-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Laparoscopy as a Diagnostic and Definitive Therapeutic Tool in Cases of Inflamed Simple Lymphatic Cysts of the Mesentery.

    Abdelaal, Abdelrahman / Sulieman, Ibnouf / Aftab, Zia / Ahmed, Ayman / Al-Mudares, Saif / Al Tarakji, Mohannad / Almuzrakchi, Ahmad / Toro, Adriana / Di Carlo, Isidoro

    Case reports in surgery

    2015  Volume 2015, Page(s) 325939

    Abstract: Mesenteric cysts are rare benign abdominal tumors. These cysts, especially those of lymphatic origin, very rarely become inflamed. The diagnosis of inflamed lymphatic cysts of the mesentery may be difficult. We herein report two cases of inflamed simple ... ...

    Abstract Mesenteric cysts are rare benign abdominal tumors. These cysts, especially those of lymphatic origin, very rarely become inflamed. The diagnosis of inflamed lymphatic cysts of the mesentery may be difficult. We herein report two cases of inflamed simple lymphatic cysts of the mesentery definitively diagnosed and excised by laparoscopy.
    Language English
    Publishing date 2015-05-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2657697-1
    ISSN 2090-6919 ; 2090-6900
    ISSN (online) 2090-6919
    ISSN 2090-6900
    DOI 10.1155/2015/325939
    Database MEDical Literature Analysis and Retrieval System OnLINE

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