Publications by authors named "M S al-Shahed"

22 Publications

Mesenteric venous thrombosis and factors associated with mortality: a statistical analysis with five-year follow-up.

J Gastrointest Surg 2009 Jul 19;13(7):1245-50. Epub 2009 Mar 19.

Department of Surgery, Riyadh Military Hospital, Riyadh, Saudi Arabia.

Objective: The objective was to study the factors associated with mortality in mesenteric venous thrombosis (MVT).

Methods: We reviewed all cases of bowel ischemia at our institute from 1984 to 2004 and identified 31 cases of MVT and compiled data concerning their demographics, risk factors, investigations, management, surgical procedures, and outcomes. Survival was analyzed for both 30-day and 5-year periods.

Results: Analysis of factors associated with mortality in our 31 case series revealed that 30-day mortality was strongly associated with colonic involvement in ischemia (p = .008) as well as short bowel syndrome (p = .028) and possibly failure to anti-coagulate the patient (p = .07). While 5-year mortality was strongly associated with "short bowel syndrome" as defined by small bowel remaining less than 100 cm (p = .031). Further study using a multivariate Cox proportional hazard analysis showed that mortality within the 30-day period was mainly related to colon ischemia with p value of .014 and an odds ratio of 17.4, while short-bowel syndrome was the predominated factor in the 5-year mortality analysis with a p value of .029 and an odds ratio of 5.

Conclusion: Thirty-day mortality for MVT is strongly associated with colonic involvement as well as "short-bowel" syndrome, while anticoagulation may be protective. Five-year survival was found to be strongly associated with "short-bowel" syndrome.
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http://dx.doi.org/10.1007/s11605-009-0833-7DOI Listing
July 2009

Imaging of uncommon and rare benign solid liver tumors.

J Med Liban 2003 Jan-Mar;51(1):38-50

Department of Diagnostic Radiology, American University of Beirut--Medical Center, Beirut, Lebanon.

In this article, we attempted to present an overview of uncommon and rare benign solid liver tumors. Table I summarizes some clinical and imaging characteristic features with a suggested diagnostic work-up and management. While clinical history and certain radiologic appearances can help making a confident diagnosis in some of these tumors, the majority requires histologic examination for a definitive diagnosis.
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July 2004

Gastrointestinal parasite infestation.

Eur Radiol 2004 Mar;14 Suppl 3:E116-31

Department of Radiology, Armed Forces Hospital, 11159 Riyadh, Saudi Arabia.

Twenty-five percent of the world's population could be suffering parasitic infestation. Highest prevalence is in underdeveloped agricultural and rural areas in the tropical and subtropical regions. In some areas incidence may reach 90% of the population. In contrast, some major economic projects intended to promote local development have, paradoxically, caused parasitic proliferation, e.g. bilharziasis in Egypt and Sudan and Chagas disease in Brazil. The commonest cosmopolitan gastrointestinal parasite is Entamoeba histolytica. Some intestinal parasite are endemic in temperate climates, e.g. Entrobius vermicularis. The AIDS epidemic has increased the prevalence and severity of parasitic disease, particularly Strongyloides stercolaris. Tropical parasites are seen in Western people who travel to tropical countries. Radiology has acquired a major role in diagnosis and management of gastrointestinal parasite infestations and their complications.
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http://dx.doi.org/10.1007/s00330-003-2041-2DOI Listing
March 2004

Living related liver transplantation in 13 cases of progressive familial intrahepatic cholestasis.

Transplant Proc 2003 Dec;35(8):3003-5

Department of Surgery, Riyadh Armed Forces Hospital, Riyadh 11159, Kingdom of Saudi Arabia.

Progressive familial intrahepatic cholestasis (PFIC) is a heterogenous group of disorders with various etiologies. Recent molecular and genetic studies have categorized the spectrum of types. Liver transplantation is a curative modality of treatment in this disease. We report our experience with 13 patients with PFIC who underwent living related liver transplantation. The follow-up periods ranged from 12 to 50 months. Two children died at 1 and 2 years posttransplantation, leading to a decrease in survival rate from 100% in the first year to 84.6%.
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http://dx.doi.org/10.1016/j.transproceed.2003.10.047DOI Listing
December 2003

Pediatric living-related liver transplantation in Saudi Arabia.

Saudi Med J 2002 Jun;23(6):640-4

Division of Hepatobiliary and Transplantation Surgery, Department of Surgery, Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.

Objective: The purpose of this paper is to report our experience of the first 29 consecutive living-related liver transplants in pediatric recipients and to demonstrate the feasibility of living-related liver transplantation in the Arab World. The first living-related liver transplantation in the Kingdom of Saudi Arabia was performed in November 1998 by Bassas et al following an appropriate period of multi-disciplinary preparation.

Methods: This study was carried out at the Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia, during the period November 1998 through to October 2001. A review of the data of the transplanted children and adult donors was carried out. The data recorded for recipients included age, sex, patient's weight, preoperative diagnosis, intraoperative surgical complications, graft size and weight, medical and surgical postoperative complications, immunosuppression, rejection and overall survival rate. Data recorded for the donors included age, sex and any postoperative complications.

Results: The most frequent indication for living-related liver transplantation in our series was metabolic liver disease. Post-operative complications included biliary leaks in 10% (N=3), vascular occlusion in 13% (N=4), acute cellular rejection in 38% (N=11), positive cytomegalovirus PP65 antigen in 38% (N=11), wound infection in 3.4% (N=one), and systemic infections in 14% (N=4). One urgent retransplantation was necessary due to thrombosis of the hepatic artery. Patient and graft survival rates are 96% and 93%. One patient, treated for acute liver failure, died 2 months post-transplant.

Conclusion: Our experience has shown pediatric living-related liver transplantation to be a success whilst alleviating the need for sending Saudi patients overseas for treatment and providing a solution to organ shortages for pediatric patients. In general, this endeavor has broadened the spectrum of our experience in surgery, anesthetics, intensive care and pediatrics.
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June 2002
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