emergency challenges, medical cases

THE PROBLEMS ...!!??

DR. TARIK 18 SAFER1439

DR. TARIK 18 SAFER1439

http://pec.cochrane.org/

http://pec.cochrane.org/

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiznZrr1ojXAhWEd5oKHTp-AyoQjRwIBw&url=https://www.xifaxan.com/about-ibs-d&psig=AOvVaw0NJvxSVZZ3cIS7odTxB7yW&ust=1508914530915355

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiznZrr1ojXAhWEd5oKHTp-AyoQjRwIBw&url=https://www.xifaxan.com/about-ibs-d&psig=AOvVaw0NJvxSVZZ3cIS7odTxB7yW&ust=1508914530915355

ABDOMEN

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwimwr68-pXXAhXHY1AKHVCwDgAQjRwIBw&url=http://www.101qs.com/885-eye-of-horus&psig=AOvVaw0qgDdHJN5_D2VvvsP5YQCA&ust=1509370783052170

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwimwr68-pXXAhXHY1AKHVCwDgAQjRwIBw&url=http://www.101qs.com/885-eye-of-horus&psig=AOvVaw0qgDdHJN5_D2VvvsP5YQCA&ust=1509370783052170

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjMjtqKy4jXAhXqNJoKHR4fAyYQjRwIBw&url=https://www.slideshare.net/NaikInayat/plain-radiography-in-acute-abdomen&psig=AOvVaw3RJXZTzsCDuCVo8GOidg5j&ust=1508911356434397

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjMjtqKy4jXAhXqNJoKHR4fAyYQjRwIBw&url=https://www.slideshare.net/NaikInayat/plain-radiography-in-acute-abdomen&psig=AOvVaw3RJXZTzsCDuCVo8GOidg5j&ust=1508911356434397

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjMjtqKy4jXAhXqNJoKHR4fAyYQjRwIBw&url=http://www.kavishi.com/torsionbloat.htm&psig=AOvVaw3RJXZTzsCDuCVo8GOidg5j&ust=1508911356434397

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjMjtqKy4jXAhXqNJoKHR4fAyYQjRwIBw&url=http://www.kavishi.com/torsionbloat.htm&psig=AOvVaw3RJXZTzsCDuCVo8GOidg5j&ust=1508911356434397

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjMjtqKy4jXAhXqNJoKHR4fAyYQjRwIBw&url=https://www.slideshare.net/sonnareach168/17-gi&psig=AOvVaw3RJXZTzsCDuCVo8GOidg5j&ust=1508911356434397

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjMjtqKy4jXAhXqNJoKHR4fAyYQjRwIBw&url=https://www.slideshare.net/sonnareach168/17-gi&psig=AOvVaw3RJXZTzsCDuCVo8GOidg5j&ust=1508911356434397

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjZ_sC5qo7XAhUJJ8AKHbriBZgQjRwIBw&url=http://www.123rf.com/photo_26990397_closeup-portrait-of-senior-executive,-old-man,-elderly-corporate-employee,-grandfather-looking-mise.html&psig=AOvVaw1pUhyZSM1QBE-WVdEFJY3f&ust=1509108752757274

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjZ_sC5qo7XAhUJJ8AKHbriBZgQjRwIBw&url=http://www.123rf.com/photo_26990397_closeup-portrait-of-senior-executive,-old-man,-elderly-corporate-employee,-grandfather-looking-mise.html&psig=AOvVaw1pUhyZSM1QBE-WVdEFJY3f&ust=1509108752757274

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&ved=0ahUKEwjQjcm-r6nXAhWP26QKHRfODy4QjRwIBw&url=https://www.webmd.com/cancer/ss/slideshow-carcinoid-symptoms&psig=AOvVaw0DIjtKBV1HQrXB0UKQ7EG9&ust=1510037845116427

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&ved=0ahUKEwjQjcm-r6nXAhWP26QKHRfODy4QjRwIBw&url=https://www.webmd.com/cancer/ss/slideshow-carcinoid-symptoms&psig=AOvVaw0DIjtKBV1HQrXB0UKQ7EG9&ust=1510037845116427

RENAL IMPAIRMENT

NERVOUS SYSTEM CONFUSION

RESPIRATORY ATELECTASIS , PNEUMONIA &

HYPOVENTILATION.

RENAL IMPAIRMENT

COMMON ESPECIALLY WITH COPD. IHD AGE > 65YO…..UP TO

30% CARDIAC RESERVE, DYSRHYTHMIAS AND

CONDUCTION ABNORMALITIES

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjM25SEtqnXAhUSyKQKHd6BBJgQjRwIBw&url=http://www.mekshat.com/vb/showthread.php?570739-%DA%E4%CF%ED-%DA%D5%DD%E6%D1-%E6%CE%C7%ED%DD%E5-%ED%E3%E6%CA-%C7%D1%CC%E6%DF%E3-%D3%C7%DA%CF%E6%E4%ED&psig=AOvVaw07wJR_gqtRxdnUU_Ho3gGx&ust=1510039593340354

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjM25SEtqnXAhUSyKQKHd6BBJgQjRwIBw&url=http://www.mekshat.com/vb/showthread.php?570739-%DA%E4%CF%ED-%DA%D5%DD%E6%D1-%E6%CE%C7%ED%DD%E5-%ED%E3%E6%CA-%C7%D1%CC%E6%DF%E3-%D3%C7%DA%CF%E6%E4%ED&psig=AOvVaw07wJR_gqtRxdnUU_Ho3gGx&ust=1510039593340354

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwifrdXmtanXAhUJEewKHXrTBpIQjRwIBw&url=https://kids.nationalgeographic.com/explore/wacky-weekend/strange-birds/&psig=AOvVaw1uiDxEDyNf28l7S3MHmTdn&ust=1510039500826424

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwifrdXmtanXAhUJEewKHXrTBpIQjRwIBw&url=https://kids.nationalgeographic.com/explore/wacky-weekend/strange-birds/&psig=AOvVaw1uiDxEDyNf28l7S3MHmTdn&ust=1510039500826424

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjFtIKkpY7XAhWMAMAKHS4nCZIQjRwIBw&url=https://sandiessnippets.wordpress.com/2013/05/21/health-check/&psig=AOvVaw1aV0PrCT1ID3VngHu2iwyj&ust=1509107387032503

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjFtIKkpY7XAhWMAMAKHS4nCZIQjRwIBw&url=https://sandiessnippets.wordpress.com/2013/05/21/health-check/&psig=AOvVaw1aV0PrCT1ID3VngHu2iwyj&ust=1509107387032503

https://image.slidesharecdn.com/colon-cancerppt-powerpoint-presentation4604/95/colon-cancerppt-powerpoint-presentation-2-728.jpg?cb=1327394635

Fecal immunochemical test (FIT)

every year90% of cases occurs after

Guaiac-based fecal occult blood test

(gFOBT) every year

Stool DNA test every 3 years

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjB4dW2lKfXAhWJKewKHcFTAdgQjRwIBw&url=http://slideplayer.com/slide/1427080/&psig=AOvVaw2beTln3EX7ZtfdsLLOaTxz&ust=1509961861422402

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjB4dW2lKfXAhWJKewKHcFTAdgQjRwIBw&url=http://slideplayer.com/slide/1427080/&psig=AOvVaw2beTln3EX7ZtfdsLLOaTxz&ust=1509961861422402

Double-Contrast Barium Enema Every 5 Years. 90% of cases occurs after age 50Colonoscopy Every 10 years

CT Colonography (Virtual Colonoscopy) Every 5

Years.

MRI Colonography

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjIuLKKwanXAhVN26QKHRSkDZ0QjRwIBw&url=http://slideplayer.com/slide/8356708/&psig=AOvVaw0GaCS2cRzCEhwcmpEXeSY0&ust=1510042550249093


Small Incision :

1 Tissue Trauma is less

2 Post op. pain is less

3 Less blood loss

4 Chances of incisional hernia are less

Mini- cholecystectomy is a minimally invasive operation, which is well tolerated, and is associated with minimal complications and conversions. When it is carried out with the surgical tool kit “Mini-assistant”, it is an alternative to laparoscopic

http://www.sciencedirect.com/science/article/pii/S1743919107001276



https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwju7J30zanXAhVQzaQKHS9hA9oQjRwIBw&url=https://cerin.wordpress.com/2010/08/10/large-waist-size-linked-to-higher-risk-of-death/&psig=AOvVaw0DbA96djaCx0tXHjMAgGhY&ust=1510046005734868

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwju7J30zanXAhVQzaQKHS9hA9oQjRwIBw&url=https://cerin.wordpress.com/2010/08/10/large-waist-size-linked-to-higher-risk-of-death/&psig=AOvVaw0DbA96djaCx0tXHjMAgGhY&ust=1510046005734868

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjI1c2Z85rXAhXGIcAKHUnKDVIQjRwIBw&url=http://www.porcelainzone.com/en/factories/gebruder-benedikt&psig=AOvVaw0VZlgiwxWXvAGW4R_6-O4o&ust=1509540479604579

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjI1c2Z85rXAhXGIcAKHUnKDVIQjRwIBw&url=http://www.porcelainzone.com/en/factories/gebruder-benedikt&psig=AOvVaw0VZlgiwxWXvAGW4R_6-O4o&ust=1509540479604579

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwizoaaX8JrXAhVDLMAKHYqTCcwQjRwIBw&url=http://slideplayer.com/slide/10962658/&psig=AOvVaw3NJbv4Rz61Awj6Xe8K6ima&ust=1509539815355679

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwizoaaX8JrXAhVDLMAKHYqTCcwQjRwIBw&url=http://slideplayer.com/slide/10962658/&psig=AOvVaw3NJbv4Rz61Awj6Xe8K6ima&ust=1509539815355679

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwizoaaX8JrXAhVDLMAKHYqTCcwQjRwIBw&url=https://www.slideshare.net/shaffar75/ultrasound-of-the-gallbladder&psig=AOvVaw3NJbv4Rz61Awj6Xe8K6ima&ust=1509539815355679

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwizoaaX8JrXAhVDLMAKHYqTCcwQjRwIBw&url=https://www.slideshare.net/shaffar75/ultrasound-of-the-gallbladder&psig=AOvVaw3NJbv4Rz61Awj6Xe8K6ima&ust=1509539815355679

SITUS INVERSUS TOTALIS

SIT IS A CHALLETNGE TO ANY LAPAROSCOPIC SURGEON

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiX95Xd6anXAhWNDuwKHcymDFgQjRwIBw&url=https://acikgunluk.net/sindrom-mirizzi-klassifikatsiya-diagnostika-lechenie/&psig=AOvVaw3U9ZNlJs-sedT5SIqjVZ5h&ust=1510053469308969

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiX95Xd6anXAhWNDuwKHcymDFgQjRwIBw&url=https://acikgunluk.net/sindrom-mirizzi-klassifikatsiya-diagnostika-lechenie/&psig=AOvVaw3U9ZNlJs-sedT5SIqjVZ5h&ust=1510053469308969

MIRIZZI SYNDROM

PROFESSOR PAPLO LUIS MIRIZZI

(1893-1964)

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwicnNar6KnXAhULGuwKHYZRA44QjRwIBw&url=http://www.hpbonline.org/article/S1365-182X(17)30699-8/fulltext&psig=AOvVaw2nz_sAQvcUqvS0JuUuJM9D&ust=1510052280016207

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwicnNar6KnXAhULGuwKHYZRA44QjRwIBw&url=http://www.hpbonline.org/article/S1365-182X(17)30699-8/fulltext&psig=AOvVaw2nz_sAQvcUqvS0JuUuJM9D&ust=1510052280016207

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiv3Kel5anXAhUB2qQKHYpvBwEQjRwIBw&url=http://slideplayer.com/slide/5716102/&psig=AOvVaw2nz_sAQvcUqvS0JuUuJM9D&ust=1510052280016207

http://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiv3Kel5anXAhUB2qQKHYpvBwEQjRwIBw&url=http://slideplayer.com/slide/5716102/&psig=AOvVaw2nz_sAQvcUqvS0JuUuJM9D&ust=1510052280016207

CONCLUSIONS: high association of gallbladder cancer in Mirizzi syndrome. Elevated CA 19-9 levels in this syndrome are indicative of a coincidental gallbladder malignancy.

intraoperative frozen section of the gallbladder in all patients presenting with Mirizzi syndrome

MIRIZZI SYNDROM & GB CANCER

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwixkO7G9JzXAhXGvRoKHYfeDXsQjRwIBw&url=https://twitter.com/kareemalkassim/status/550686188227416064&psig=AOvVaw0PDBFOyWsnZAYL_BboATlP&ust=1509609657676702

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwixkO7G9JzXAhXGvRoKHYfeDXsQjRwIBw&url=https://twitter.com/kareemalkassim/status/550686188227416064&psig=AOvVaw0PDBFOyWsnZAYL_BboATlP&ust=1509609657676702

ىفالطبيب جعله هللا سببا لحياة إنسان إن وفقه

ويجعله سببا لفقدان الحياة لو جهل .. القرار

.السبيل النتشال الروح إلى طريق الفرار

وموت يكتب .. الموتحياة تكتب من

من الحياة

النجومىطارق

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjWu83_9o3XAhXKaFAKHXg_CiMQjRwIBw&url=https://www.youtube.com/watch?v%3DVzsF_AeMoIs&psig=AOvVaw1Nf9s7Oa37V7s2ORcJB950&ust=1509094966522188

https://www.google.com.sa/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjWu83_9o3XAhXKaFAKHXg_CiMQjRwIBw&url=https://www.youtube.com/watch?v%3DVzsF_AeMoIs&psig=AOvVaw1Nf9s7Oa37V7s2ORcJB950&ust=1509094966522188

ن ومن يتق هللا يجعل له مخرجا ويرزقه م)صدق هللا العظيم( حيث اليحتسب

AND WHOSOEVER FEARS ALLAH AND KEEPS

HIS DUTY TO HIM , GOD WILL MAKE A WAY

FOR HIM TO GET OUT (from ever difficulty).

AND WILL PROVIDE ( HIM l HER ) FROM

(SOURCES ) HE l SHE NEVER COULD

IMAGINE.( THE NOBLE QURAN )

emergency challenges, medical cases

Education