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H M Atta

Publications and source records attributed to H M Atta.

11 recordsLinked to original sources
PubMed1999

The association of absent suspensory ligaments of the liver and Marfan syndrome.

Gastrointestinal manifestations of collagen diseases are very rare. The authors report on a patient who has features of Marfan syndrome with mobile liver caused by the absence of its suspensory ligaments. This patient presented with an acute intestinal obstruction secondary to a congenital band across the distal transverse colon. Recurrent intestinal obstruction after resection of the band necessitated the performance of partial colectomy with ileotransverse anastomosis. The patient's phenotypic features are suggestive but not diagnostic of Marfan syndrome. Nevertheless, isolated skeletal manifestations of Marfan syndrome with documented FBN1 gene mutation have been reported, suggesting the existence of milder forms of the syndrome not exhibiting the classic diagnostic criteria. The authors postulate that the absence of suspensory ligaments of the liver in this patient could be attributed to the defective connective tissue of Marfan syndrome.

Adolescent↗
PubMed1999

Organ injury scaling system can be used to predict length of stay in patients with penetrating neck injuries.

Predicting probability of survival of trauma patients has received greater attention than predicting other trauma outcomes such as length of stay. Most trauma scoring systems depend on the anatomic description of injuries of the Abbreviated Injury Score (AIS). The recently introduced Organ Injury Scale (OIS) was developed to give more precise and comprehensive anatomic description of injuries. Unlike the AIS, it also avoids including immediate injury sequelae, such as the amount of hemorrhage. This retrospective study was performed to assess the degree of association between the sum of grades of penetrating neck injuries using the OIS and the length of hospital stay. There were 31 males and 7 females, with ages ranging from 13 to 65 years and a mean of 31 years. The length of hospital stay ranged between 1 and 34 days, with a mean of 7.0 +/- 6.5 days. There were 32 vascular, 7 esophageal, and 7 tracheal injuries. The sum of the OIS grades correlates significantly with the length of hospital stay (r = 0.78; P < 0.005). This study suggests that the OIS system can be used to predict the length of hospital stay. It proposes also that the OIS replaces similar anatomic components of the AIS-based scoring systems.

Adolescent↗
PubMed1998

Penetrating neck trauma: lack of universal reporting guidelines.

Penetrating neck injuries constitute a heterogeneous group. Two different classifications of zones of the neck exist in trauma literature. Injuries crossing the midline are not accurately reported. Records of 50 patients with stab wounds (30), gunshot wounds (GSWs; 17), and shotgun wounds (SGWs; 3) were reviewed. Injuries involved zone I in 8 patients, zone II in 37 patients, zone III in 8 patients, posterior triangle in 6 patients, and multiple zones in 5 patients. All 11 patients with transcervical GSWs and SGWs sustained vascular or aerodigestive injuries and had longer hospital stays (14.0 +/- 2.6 days) compared with patients with other GSWs (6.6 +/- 2.0 days) and stab wounds (3.6 +/- 0.5 days). We emphasize the lethal potential of transcervical GSWs and SGWs. We suggest that these particular injuries be reported separately. We recommend the universal adoption of one system of classification of neck zones.

Adolescent↗
PubMed1997

Thoracotomy versus video-assisted thoracoscopic pleurectomy for spontaneous pneumothorax.

We reviewed our experience with thoracotomy (TH) and video-assisted thoracoscopic pleurectomy (VAT) for the treatment of recurrent spontaneous pneumothorax. Nine patients underwent 10 VATs. One patient had bilateral procedures 1 week apart. Nine patients underwent 10 THs. One patient had bilateral TH at the same session. The mean duration of postoperative hospital stay for VAT and TH was 5.7 days and 6.4, respectively. VAT operative time was longer (128 vs 93.6 min in the TH group); however, the estimated blood loss was larger in the TH group (136 vs 108.3 ml in the VAT group). There were no deaths in either group. In the VAT group, one patient had recurrence of pneumothorax 1 month after surgery. In the TH group, there was no recurrence of pneumothorax, but one patient had chronic pain at the site of the thoracotomy incision. One patient was lost to follow-up in each group. We conclude that VAT is a safe and reasonably effective treatment of spontaneous pneumothorax. However, large series with long-term follow-up are needed to place this procedure in its proper perspective.

Adult↗
PubMed1997

Delayed presentation of popliteal artery pseudoaneurysm following blunt trauma.

Popliteal artery pseudoaneurysms are not uncommon. They may result from penetrating or blunt trauma, arterial reconstructive surgery, invasive diagnostic or surgical orthopedic procedures, and perigenicular neoplasia. We report two patients with popliteal artery pseudoaneurysm diagnosed 3 months and 3 weeks, respectively, after blunt trauma. These two patients as well as many patients reported in the literature had palpable distal pulses and no obvious clinical signs of arterial injury following various forms of trauma. Arteriography in these circumstances is usually abandoned because of the low yield and the possible risk of complications. However, as we illustrate in this report, noninvasive diagnostic modalities such as duplex ultrasound and magnetic resonance arteriography are both safe and accurate for early detection of popliteal artery pseudoaneurysm. Once diagnosed, standard vascular reconstruction should be performed to prevent potential complications.

Adult↗
PubMed1992

The effect of liver denervation on hepatic hemodynamics during hypovolemic shock in swine.

This study tested the hypothesis that the denervated liver is more susceptible to hypovolemic shock than the normal liver. Fourteen swine, seven nondenervated and seven after liver denervation, were studied during hypovolemic shock to 50% of baseline blood pressure. Hepatic artery and portal vein flows were measured using transonic flow probes, and cardiac output and central venous pressure were measured using Swan-Ganz catheters. Hepatic artery flow fell equivalently in the two groups, from 132 +/- 71 to 94 +/- 17 ml/min in the nondenervated group compared with 149 +/- 56 to 91 +/- 55 ml/min in the denervated group. In contrast, portal flow in the denervated group (276 +/- 71 to 119 +/- 53 ml/min) fell significantly (p less than 0.001) more than in the nondenervated group (289 +/- 135 to 194 +/- 70 ml/min). The 58% reduction from baseline in portal flow in the denervated group compared with the 30% reduction in the nondenervated group suggests that the normal compensatory mechanism to maintain portal flow during hypovolemic shock is neurally mediated. It can be hypothesized that sensory afferent fibers might initiate a feedback to splanchnic vasodilatation in response to reduced portal flow. This study supports the hypothesis that the denervated liver is more susceptible to hypovolemic shock.

Animals↗
PubMed1991

Selective splenocaval shunt. Report of 26 cases and review of the literature.

Splenocaval shunting was performed in 26 patients for the treatment of variceal bleeding. The indications for this alternative selective shunt were congenital anomalies of the left renal vein, inadequate outflow from the left renal vein on preoperative venography, or an anatomic relationship of the splenic vein favoring direct splenocaval rather than splenorenal anastomosis. Technical considerations in which splenocaval shunts differ from distal splenorenal shunting relate to exposure of the vena cava. Operative mortality was 7.7% (2/26). Immediate shunt patency was documented in 23 of 24 patients studied, and all 14 shunts studied at 13 to 57 months were patent. Portal perfusion was maintained in 95% (20/21) of the patients when studied at 7 to 10 days after shunting and in 57% (8/14) at late follow-up. This experience with distal splenocaval shunting has reaffirmed its place as an alternative technique to selective distal splenorenal shunts, particularly when the left renal vein is abnormal.

Adolescent↗