Youssef shaban - Academia.edu (original) (raw)

Papers by Youssef shaban

Surgery in Practice and Science

Hernia, 2003

The authors report a case of gangrenous acute appendicitis in the sac of an inguinal hernia (Amya... more The authors report a case of gangrenous acute appendicitis in the sac of an inguinal hernia (Amyand's hernia). After a review of the literature, they emphasise the extreme rarity of the c~se rep?r~ed, they underline how the clinical picture IS highly sirnilar to that of a strangulated inguinal hernia. They affirm that appendicectomy and hernioplasty~ay be performed at the same time, si~ce the repair ?f .the hernia should be performed without prosthesis implantation due to the contamination of the operating field.

Actas Urológicas Españolas, 2003

RESUMEN "LIPOSARCOMA DEDIFERENCIADO DEL CORDÓN ESPERMÁTICO: DEGENERACIÓN DE UN LIPOMA PREVIO RESE... more RESUMEN "LIPOSARCOMA DEDIFERENCIADO DEL CORDÓN ESPERMÁTICO: DEGENERACIÓN DE UN LIPOMA PREVIO RESECADO" Los sarcomas del cordón espermático son tumores de rara presentación. El liposarcoma dediferenciado representa sólo un 10% de los sarcomas del cordón espermático. Estos suelen ser tumores de gran tamaño y con una histología caracterizada por ser un liposarcoma bien diferenciado con áreas de sarcoma de alto grado. El TAC y la ecografía nos informarán del volumen, localización, homogeneidad de la masa, así como de las posibles adenopatías pelvianas y retroperitoneales. Son útiles en el seguimiento después del tratamiento. Nosotros presentamos un liposarcoma dediferenciado, de cordón espermático, al que previamente, se le extirpó en tres ocasiones lipomas en el mismo cordón espermático. Creemos que se trata de una degeneración del lipoma previo resecado. El tratamiento es la orquiectomía radical por vía inguinal amplia, siendo la radioterapia y la quimioterapia de ayuda complementaria, con valor incierto. Suelen presentar recidivas locales frecuentes después de la cirugía, pudiendo presentar metástasis hematógenas y en nódulos pelvianos. Presentan una supervivencia a los 5 y 10 años, de un 75% y 63% respectivamente.

The American Surgeon, 2020

The American Surgeon, 2020

Annals of Medicine and Surgery, 2020

Introduction: A true brachial artery aneurysm is a rare pathology with an incidence of 0.17% of a... more Introduction: A true brachial artery aneurysm is a rare pathology with an incidence of 0.17% of all peripheral artery aneurysms. This pathology can manifest devastating complications if overlooked, however, a high index of suspicion coupled with a thorough history and physical allows easy diagnosis. We present a rare case of the oldest documented patient with a true brachial artery aneurysm with idiopathic etiology. Presentation of case: An 83-year-old gentleman presented with left upper extremity pain, erythema, and swelling for 1 week. He denied trauma to the area. Examination revealed a pulsatile mass of the antecubital fossa and decreased distal pulses. Imaging illustrated a 9mm aneurysm of the brachial artery with stenosis of the radial artery and non-enhancement of the origin of the ulnar artery. The patient underwent a brachial aneurysm excision, radial and ulnar embolectomy, and brachial to ulnar and radial artery bypass. Postoperatively, palpable pulses were appreciated in the radial and ulnar arteries. Pathology demonstrated a true aneurysm. The patient's postoperative course was uneventful and follow-up 6 months later revealed normal perfusion. Discussion: This case highlights the importance of maintaining a high index of suspicion coupled with a thorough history and physical examination when encountering neurovascular complaints of the upper extremities. Operative intervention even in asymptomatic patients is warranted due to a high complication rate of 33%. Conclusion: More research into the pathophysiology of this rare pathology is needed to further understand, prevent, or mitigate its complications.

Annals of Medicine and Surgery, 2020

Introduction: Vascular injuries account for approximately 2-4% of trauma admissions with only 2.5... more Introduction: Vascular injuries account for approximately 2-4% of trauma admissions with only 2.5% of these being traumatic arteriovenous fistulas (AVFs). We offer a case report of a traumatic AVF and review of the literature. Presentation of case: A 40-year-old male presented following 4 gunshot wounds, 2 in the forearm and 2 in the left upper thigh. The patient had decreased range of motion and paresthesia of the left lower extremity with palpable pulses and adequate capillary refill in all extremities. A CT angiogram demonstrated a left traumatic AVF involving the left deep femoral artery and left common femoral vein with an adjacent bullet fragment. The patient was taken to the operating room and underwent an exploration of the left groin, repair of the traumatic AVF, and removal of bullet fragment. The venous aspect had a grade IV injury and was ligated. The arterial defect was debrided to healthy tissue and repaired primarily. The patient recovered from his injuries with adequate ambulation and resolution of lower extremity edema. He was discharged home on postoperative day 4 on aspirin and a compression stocking. Discussion: Traumatic AVFs are rare, with up to 70% diagnosed in a delayed fashion. Clinicians must maintain a high index of suspicion to correctly diagnose and manage this injury to avoid potential morbidity and mortality. Conclusion: Despite literature accounts of surgeons' experience, this pathology is lacking level one evidencebased standardized surgical management algorithms. Controversy exists regarding venous repair methods.

American Journal of Case Reports, 2020

Rare disease Background: Diaphragmatic rupture is a rare pathology that reported in less than 0.5... more Rare disease Background: Diaphragmatic rupture is a rare pathology that reported in less than 0.5% of all trauma cases, with signs and symptoms that can easily be misdiagnosed. Clinicians must maintain a high index of suspicion to correctly diagnose and manage this pathology. We present a rare case of a large diaphragmatic rupture with transthoracic gastric and colon herniation that was successfully repaired, along with a literature review. Case Report: A 59-year-old woman presented to our Trauma Center after being involved in a motor vehicle collision. She complained of chest and abdominal pain, with decreased breath sounds on the left side. CT imaging revealed discontinuity of the left hemidiaphragm, with intrathoracic herniation of stomach and colon with multiple other injuries. The patient was taken for an emergent laparotomy. The diaphragmatic rupture measured 20 cm in length, with a stellate component. After ensuring complete reduction of the herniated organs, the diaphragmatic defect was primarily repaired. The patient recovered from her injuries and was doing well at last followup in the clinic. Conclusions: This case highlights the importance of diaphragmatic rupture and its associated intra-abdominal injuries when treating trauma patients. With missed diaphragmatic injuries leading to a potential morbidity rate of 30% and mortality rate as high as 10%, the clinician must have a high index of suspicion to correctly diagnose and manage this pathology in a timely fashion. More research is needed to provide surgeons with evidence-based standardized therapies for dealing with these rare pathologies to ensure optimal patient outcomes.

Annals of Medicine and Surgery, 2019

Background: Clinicians must maintain an index of suspicion to diagnose an anorectal foreign body ... more Background: Clinicians must maintain an index of suspicion to diagnose an anorectal foreign body (FB). The patient may not be forthcoming with information secondary to embarrassment or possibly psychiatric issues. Providers must express empathy and compassion while maintaining nonjudgmental composure. Despite accounts of anal FB insertion, this pathology is lacking level one evidence-based surgical algorithms. Case presentation: A 46-year-old male psychiatric patient presented in septic shock, complaining of lower abdominal/pelvic pain starting 1 week prior. His past medical history was significant for schizophrenia, bipolar disorder, and noncompliance with medications. CT of the abdomen/pelvis revealed a rectal perforation with free air and a FB which appeared to be a screwdriver. Fluid resuscitation and broad-spectrum antibiotics were administered. In the operating room, after unsuccessful transrectal removal, an exploratory laparotomy was performed. The metallic end of the screwdriver had perforated the rectosigmoid. Resection of the perforated rectum with removal of the screwdriver, incision and drainage of a large right buttock abscess and colostomy was performed. The patient recovered and was discharged to behavioral health. At 2 weeks follow-up the patient was doing well with a functioning colostomy and reversal was planned for later this year. Conclusion: This case highlights the importance of maintaining a high index of suspicion when encountering psychiatric patients with nonspecific lower abdominal or anorectal pain with inconsistent presentations. Controversy exists regarding the type of surgical treatment in case of anorectal perforation. More research is needed to provide surgeons with evidence-based standardized methods for dealing with these rare pathologies.

American Journal of Case Reports, 2019

Rare disease Background: First described in 1863 by French surgeon Victor-Auguste-François Morel-... more Rare disease Background: First described in 1863 by French surgeon Victor-Auguste-François Morel-Lavallée, the Morel-Lavallée lesion (MLL) is a closed traumatic soft-tissue degloving injury. These lesions most commonly occur following motor vehicle collisions (MVCs). The pathophysiology stems from a shearing force that causes separation of the soft tissue from the fascia underneath, which disrupts the vasculature and lymphatic vessels that perforate between the tissue layers. Timely diagnosis and treatment are imperative, as a delayed diagnosis can lead to complications. However, at present there is no universally accepted treatment algorithm. Case Report: A 60-year-old morbidly obese woman presented after being involved in an MVC. She complained of abdominal tenderness in the right lower quadrant, with no evidence of peritonitis. Cross-sectional imaging revealed hemoperitoneum and a traumatic posterior abdominal wall/lumbar hernia on the right, with multiple contusions in the subcutaneous abdomen. The patient was taken to the operating room and underwent an exploratory laparotomy that revealed a large abdominal Morel-Lavallée lesion (MLL) along with a traumatic abdominal wall hernia (TAWH). There was also a mesenteric avulsion injury with an associated ileocecal injury. The patient underwent resection of the involved bowel, with primary anastomosis, debridement of the abdominal wall degloving injury, and expectant management for the hernia defect. She recovered from the injuries and was doing well when followed up in the clinic, with follow-up to repair the hernia in the near future. Conclusions: More research is needed to provide surgeons with evidence-based standardized therapies for dealing with these rare pathologies to ensure optimal patient outcomes.

Surgery in Practice and Science

Hernia, 2003

The authors report a case of gangrenous acute appendicitis in the sac of an inguinal hernia (Amya... more The authors report a case of gangrenous acute appendicitis in the sac of an inguinal hernia (Amyand's hernia). After a review of the literature, they emphasise the extreme rarity of the c~se rep?r~ed, they underline how the clinical picture IS highly sirnilar to that of a strangulated inguinal hernia. They affirm that appendicectomy and hernioplasty~ay be performed at the same time, si~ce the repair ?f .the hernia should be performed without prosthesis implantation due to the contamination of the operating field.

Actas Urológicas Españolas, 2003

RESUMEN "LIPOSARCOMA DEDIFERENCIADO DEL CORDÓN ESPERMÁTICO: DEGENERACIÓN DE UN LIPOMA PREVIO RESE... more RESUMEN "LIPOSARCOMA DEDIFERENCIADO DEL CORDÓN ESPERMÁTICO: DEGENERACIÓN DE UN LIPOMA PREVIO RESECADO" Los sarcomas del cordón espermático son tumores de rara presentación. El liposarcoma dediferenciado representa sólo un 10% de los sarcomas del cordón espermático. Estos suelen ser tumores de gran tamaño y con una histología caracterizada por ser un liposarcoma bien diferenciado con áreas de sarcoma de alto grado. El TAC y la ecografía nos informarán del volumen, localización, homogeneidad de la masa, así como de las posibles adenopatías pelvianas y retroperitoneales. Son útiles en el seguimiento después del tratamiento. Nosotros presentamos un liposarcoma dediferenciado, de cordón espermático, al que previamente, se le extirpó en tres ocasiones lipomas en el mismo cordón espermático. Creemos que se trata de una degeneración del lipoma previo resecado. El tratamiento es la orquiectomía radical por vía inguinal amplia, siendo la radioterapia y la quimioterapia de ayuda complementaria, con valor incierto. Suelen presentar recidivas locales frecuentes después de la cirugía, pudiendo presentar metástasis hematógenas y en nódulos pelvianos. Presentan una supervivencia a los 5 y 10 años, de un 75% y 63% respectivamente.

The American Surgeon, 2020

The American Surgeon, 2020

Annals of Medicine and Surgery, 2020

Introduction: A true brachial artery aneurysm is a rare pathology with an incidence of 0.17% of a... more Introduction: A true brachial artery aneurysm is a rare pathology with an incidence of 0.17% of all peripheral artery aneurysms. This pathology can manifest devastating complications if overlooked, however, a high index of suspicion coupled with a thorough history and physical allows easy diagnosis. We present a rare case of the oldest documented patient with a true brachial artery aneurysm with idiopathic etiology. Presentation of case: An 83-year-old gentleman presented with left upper extremity pain, erythema, and swelling for 1 week. He denied trauma to the area. Examination revealed a pulsatile mass of the antecubital fossa and decreased distal pulses. Imaging illustrated a 9mm aneurysm of the brachial artery with stenosis of the radial artery and non-enhancement of the origin of the ulnar artery. The patient underwent a brachial aneurysm excision, radial and ulnar embolectomy, and brachial to ulnar and radial artery bypass. Postoperatively, palpable pulses were appreciated in the radial and ulnar arteries. Pathology demonstrated a true aneurysm. The patient's postoperative course was uneventful and follow-up 6 months later revealed normal perfusion. Discussion: This case highlights the importance of maintaining a high index of suspicion coupled with a thorough history and physical examination when encountering neurovascular complaints of the upper extremities. Operative intervention even in asymptomatic patients is warranted due to a high complication rate of 33%. Conclusion: More research into the pathophysiology of this rare pathology is needed to further understand, prevent, or mitigate its complications.

Annals of Medicine and Surgery, 2020

Introduction: Vascular injuries account for approximately 2-4% of trauma admissions with only 2.5... more Introduction: Vascular injuries account for approximately 2-4% of trauma admissions with only 2.5% of these being traumatic arteriovenous fistulas (AVFs). We offer a case report of a traumatic AVF and review of the literature. Presentation of case: A 40-year-old male presented following 4 gunshot wounds, 2 in the forearm and 2 in the left upper thigh. The patient had decreased range of motion and paresthesia of the left lower extremity with palpable pulses and adequate capillary refill in all extremities. A CT angiogram demonstrated a left traumatic AVF involving the left deep femoral artery and left common femoral vein with an adjacent bullet fragment. The patient was taken to the operating room and underwent an exploration of the left groin, repair of the traumatic AVF, and removal of bullet fragment. The venous aspect had a grade IV injury and was ligated. The arterial defect was debrided to healthy tissue and repaired primarily. The patient recovered from his injuries with adequate ambulation and resolution of lower extremity edema. He was discharged home on postoperative day 4 on aspirin and a compression stocking. Discussion: Traumatic AVFs are rare, with up to 70% diagnosed in a delayed fashion. Clinicians must maintain a high index of suspicion to correctly diagnose and manage this injury to avoid potential morbidity and mortality. Conclusion: Despite literature accounts of surgeons' experience, this pathology is lacking level one evidencebased standardized surgical management algorithms. Controversy exists regarding venous repair methods.

American Journal of Case Reports, 2020

Rare disease Background: Diaphragmatic rupture is a rare pathology that reported in less than 0.5... more Rare disease Background: Diaphragmatic rupture is a rare pathology that reported in less than 0.5% of all trauma cases, with signs and symptoms that can easily be misdiagnosed. Clinicians must maintain a high index of suspicion to correctly diagnose and manage this pathology. We present a rare case of a large diaphragmatic rupture with transthoracic gastric and colon herniation that was successfully repaired, along with a literature review. Case Report: A 59-year-old woman presented to our Trauma Center after being involved in a motor vehicle collision. She complained of chest and abdominal pain, with decreased breath sounds on the left side. CT imaging revealed discontinuity of the left hemidiaphragm, with intrathoracic herniation of stomach and colon with multiple other injuries. The patient was taken for an emergent laparotomy. The diaphragmatic rupture measured 20 cm in length, with a stellate component. After ensuring complete reduction of the herniated organs, the diaphragmatic defect was primarily repaired. The patient recovered from her injuries and was doing well at last followup in the clinic. Conclusions: This case highlights the importance of diaphragmatic rupture and its associated intra-abdominal injuries when treating trauma patients. With missed diaphragmatic injuries leading to a potential morbidity rate of 30% and mortality rate as high as 10%, the clinician must have a high index of suspicion to correctly diagnose and manage this pathology in a timely fashion. More research is needed to provide surgeons with evidence-based standardized therapies for dealing with these rare pathologies to ensure optimal patient outcomes.

Annals of Medicine and Surgery, 2019

Background: Clinicians must maintain an index of suspicion to diagnose an anorectal foreign body ... more Background: Clinicians must maintain an index of suspicion to diagnose an anorectal foreign body (FB). The patient may not be forthcoming with information secondary to embarrassment or possibly psychiatric issues. Providers must express empathy and compassion while maintaining nonjudgmental composure. Despite accounts of anal FB insertion, this pathology is lacking level one evidence-based surgical algorithms. Case presentation: A 46-year-old male psychiatric patient presented in septic shock, complaining of lower abdominal/pelvic pain starting 1 week prior. His past medical history was significant for schizophrenia, bipolar disorder, and noncompliance with medications. CT of the abdomen/pelvis revealed a rectal perforation with free air and a FB which appeared to be a screwdriver. Fluid resuscitation and broad-spectrum antibiotics were administered. In the operating room, after unsuccessful transrectal removal, an exploratory laparotomy was performed. The metallic end of the screwdriver had perforated the rectosigmoid. Resection of the perforated rectum with removal of the screwdriver, incision and drainage of a large right buttock abscess and colostomy was performed. The patient recovered and was discharged to behavioral health. At 2 weeks follow-up the patient was doing well with a functioning colostomy and reversal was planned for later this year. Conclusion: This case highlights the importance of maintaining a high index of suspicion when encountering psychiatric patients with nonspecific lower abdominal or anorectal pain with inconsistent presentations. Controversy exists regarding the type of surgical treatment in case of anorectal perforation. More research is needed to provide surgeons with evidence-based standardized methods for dealing with these rare pathologies.

American Journal of Case Reports, 2019

Rare disease Background: First described in 1863 by French surgeon Victor-Auguste-François Morel-... more Rare disease Background: First described in 1863 by French surgeon Victor-Auguste-François Morel-Lavallée, the Morel-Lavallée lesion (MLL) is a closed traumatic soft-tissue degloving injury. These lesions most commonly occur following motor vehicle collisions (MVCs). The pathophysiology stems from a shearing force that causes separation of the soft tissue from the fascia underneath, which disrupts the vasculature and lymphatic vessels that perforate between the tissue layers. Timely diagnosis and treatment are imperative, as a delayed diagnosis can lead to complications. However, at present there is no universally accepted treatment algorithm. Case Report: A 60-year-old morbidly obese woman presented after being involved in an MVC. She complained of abdominal tenderness in the right lower quadrant, with no evidence of peritonitis. Cross-sectional imaging revealed hemoperitoneum and a traumatic posterior abdominal wall/lumbar hernia on the right, with multiple contusions in the subcutaneous abdomen. The patient was taken to the operating room and underwent an exploratory laparotomy that revealed a large abdominal Morel-Lavallée lesion (MLL) along with a traumatic abdominal wall hernia (TAWH). There was also a mesenteric avulsion injury with an associated ileocecal injury. The patient underwent resection of the involved bowel, with primary anastomosis, debridement of the abdominal wall degloving injury, and expectant management for the hernia defect. She recovered from the injuries and was doing well when followed up in the clinic, with follow-up to repair the hernia in the near future. Conclusions: More research is needed to provide surgeons with evidence-based standardized therapies for dealing with these rare pathologies to ensure optimal patient outcomes.