Areej Rashad

Farwaniya Hospital

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Ahmed A. Shoulah

Benha University

Emad Abdel Hafez

Benha University

Mohammed Heyba

Kuwait Institute for Medical Specialization

Abdul-Aziz Al-Fadhli

Farwaniya Hospital

H.R. Mosalam

Benha University

Cooperative Institutions

Benha University

Kuwait Institute for Medical Specialization

Kuwait University

Farwaniya Hospital

Amiri Hospital

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Detection and Management of Intraoperative Pneumothorax during Laparoscopic Cholecystectomy

Case Reports in Anesthesiology (2020)

Mohammed Heyba Areej Rashad Abdul-Aziz Al-Fadhli

Intraoperative pneumothorax is a rare but potentially lethal complication during general anesthesia. History of lung disease, barotrauma, and laparoscopic surgery increase the risk of developing intraoperative pneumothorax. The diagnosis during surgery could be difficult because the signs are often nonspecific. We report a case of a middle-aged gentleman who developed right pneumothorax during an elective laparoscopic cholecystectomy. The patient had no risk factors for adverse events during the preoperative assessment (ASA1). The patient underwent general anesthesia and was put on mechanical ventilation. The first signs of abnormality immediately after surgical port insertion were tachycardia and low oxygen saturation in addition to sings of airway obstruction. The diagnosis of pneumothorax was made clinically by chest auscultation and later confirmed by intraoperative chest radiograph. Supportive treatment was started immediately through halting the surgery and manually ventilating the patient using 100% oxygen. Definitive treatment was then done by inserting an intercostal tube. After stabilizing the patient, the surgery was completed; then, the patient was extubated and shifted to the surgical ward. Postoperative computed tomography (CT) scan was done and showed only minimal liver laceration. The patient was discharged after removing the intercostal tube and was stable at the follow-up visit. Therefore, it is important to have a high index of suspicion to early detect and treat such complication. In addition, good communication with the surgeon and use of available diagnostic tools will aid in the proper management of such cases.

Chest radiograph

Chest tube

Auscultation

10.1155/2020/9273903

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Delayed Breast Reconstruction Evaluation Following Mastectomy Utilisting Transverse Rectus Abdominis Myocutaneous Flap Versus Latissimus Dorsi Flap Reconstruction

Benha Journal of Applied Sciences (2019)

H.R. Mosalam Emad Abdel Hafez Ahmed A. Shoulah Areej Rashad

During the last century, breast reconstruction after mastectomy has become an important part of comprehensive treatment for patients who have breast cancer.comparison patients after delayed breast reconstruction Following Mastectomy Utilisting transverse Rectus Abdominis Myocutaneous Flap Versus Latissimus Dorsi Flap Reconstruction due to breast cancer.This study include 22 patients with surgical history of modified radical mastectomy and operated for delayed breast reconstruction with pedicled TRAM flap and pedicled LD flap .comparative study between to type of flap in many items such as operative time (in minutes), length of hospital stay (in days), post operative complications and hospital readmission, patient satisfaction.latissimus dorsi flap however its limitation of patient selection is low than pedicled tram in hostipal stay and flap necrosis without major doner site complication of abdominal bluging and with low incidence of systemic complication of DVT and pulmonary embolism.TRAM procedure is good for patient adequate lower abdominal wall tissue who desire abdominoplastic result beside breast reconstruction.

Rectus abdominis muscle

Latissimus dorsi muscle

Modified Radical Mastectomy

10.21608/bjas.2019.159023

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