Clinico-pathological patterns of a rare presentation of abdominal neuroblastoma in children

Background: To study the diagnosis, management, and outcome of abdominal neuroblastoma (NBL) in infants and children and also the behavior of some rare types. Patients and Methods: This is a retrospective review of 46 infants and children having abdominal NBL at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia and Tanta University Hospital, Tanta, Egypt (a joint study) between February 2008 and January 2012. The patients′ medical records were reviewed for demographic details, clinical presentations, histopathology, radiological diagnosis, management, and outcome. Results: Of the 46 patients, 5 (10.7%), three males and two females, aged 1.5-6.5 years (mean: 4.5 years) had rare types of NBL (one bilateral NBL, one pelvic NBL, one pelvic-abdominal, and there were two cases of ganglioneuroblastoma). Three patients (two ganglioneuroblastoma and one pelvic) underwent complete surgical removal of the tumor with a good disease survival, whereas the other two patients (two bilateral and one pelviabdominal) had advanced disease and received palliative chemoradiotherapy. The remaining 41 patients, 23 males (56.1%) and 18 females (43.9%), with mean age 3.9 years (range: 1-7 years), had unilateral abdominal NBL. Twelve of them had resectable tumor and underwent primary surgical removal of the tumor, whereas the remaining 29 patients had unresectable tumor and received pre-operative chemotherapy with good response of the tumor in seven patients and no response in the remaining 22 patients. Conclusion: Primary complete surgical removal of tumor is advisable in localized NBL with a good outcome, whereas in advanced cases, it is better to start with pre-operative chemotherapy to downsize the tumour mass and safe delayed surgical excision. An increase in patient′s age is associated with advanced stage of NBL and poor prognosis except in ganglioneuroblastoma cases due to maturation of tumor cells

A Very Rare Basidiobolomycosis Case Presented with Cecal Perforation and Concomitant Hepatic Involvement in an Elderly Male Patient: A Case Study

This is a case report of Basidiobolomycosis in a 65-year-old male patient from Jizan presenting with colonic perforation and concomitant liver involvement from February 2021 to July 2021. To control the infection, the patient underwent colonic resection and segmental liver resection, as well as three antifungal drugs. The treatment was successful, and the condition was completely resolved

Impact of COVID-19 Pandemic Lockdown on the Prognosis, Morbidity, and Mortality of Patients Undergoing Elective and Emergency Abdominal Surgery: A Retrospective Cohort Study in a Tertiary Center, Saudi Arabia

The SARS-CoV-2 pandemic’s main concerns are limiting the spread of infectious diseases and upgrading the delivery of health services, infrastructure, and therapeutic provision. The goal of this retrospective cohort study was to evaluate the emergency experience and delay of elective abdominal surgical intervention at King Abdul-Aziz University Hospital from October 2019 to October 2020, with a focus on post-operative morbidity and mortality before and during the COVID-19 pandemic. This study compares two groups of patients with emergent and elective abdominal surgical procedures between two different periods; the population was divided into two groups: the control group, which included 403 surgical patients, and the lockdown group, which included 253 surgical patients. During the lockdown, surgical activity was reduced by 37.2% (p = 0.014), and patients were more likely to require reoperations and blood transfusions during or after surgery (p= 0.002, 0.021, and 0.018, respectively). During the lockdown period, the average length of stay increased from 3.43 to 5.83 days (p = 0.002), and the patients who developed complications (53.9%) were more than those in the control period (46.1%) (p = 0.001). Our tertiary teaching hospital observed a significant decline in the overall number of surgeries performed during the COVID-19 pandemic and lockdown period. During the lockdown, abdominal surgery was performed only on four patients; they were positive for COVID-19. Three of them underwent exploratory laparotomy; two of the three developed shock post-operative; one patient had colon cancer (ASA score 3), one had colon disease (ASA score 2), and two had perforated bowels (ASA scores 2 and 4, respectively). Two out of four deaths occurred after surgery. Our results showed the impact of the COVID-19 lockdown on surgical care as both 30-day mortality and total morbidity have risen considerably