Conference Schedule

Day1: December 2, 2019

Keynote Forum

Biography

Nicole Alyssa S. Cua completed her medical degree from Our Lady of Fatima University. She is currently serving as a first-year Radiology resident at Quezon City General Hospital in the Philippines.
 

Abstract

Sirenomelia, also known as mermaid syndrome, is a rare congenital developmental disorder characterized by anomalies of the lower spine and the lower limbs. Partial or complete fusion of the legs may occur. Other conditions may be present such as spina bifida, imperforate anus, or cardiac anomalies. The cause of sirenomelia is unknown with an incidence rate of 1 in 60,000-100,000 births. The author presents a case of a newborn presenting with single lower extremity, single foot, spina bifida, and imperforate anus. Scout film revealed the fusion of the femur and tibia. Surgical separation of the fused lower extremities may be done, however, sirenomelia is usually fatal in the newborn period.

Biography

Mohamed Shirazy has completed his Master degree in Critical Care Medicine from Alexandria University. He then completed the Euorpean Diploma of Intensive Care Medicine (EDIC), and the Membership of the Royal Collage of Emergency Medicine (MRCEM). He is currently a Senior registrar of Critical Care Medicine in King Hamad University Hospital, Bahrain and Honorary lecturer in the Royal college of surgeons of Ireland (RCSI), Bahrain.

Abstract

Metformin-associated lactic acidosis (MALA) is the most serious and life-threatening adverse effect of Metformin. It’s presentations vary from nausea, vomiting, abdominal pain, and cardiac arrhythmias up to vasodilator shock which is characterized decreased systemic vascular resistance (SVR). Vasopressors as Nor-epinephrine and Epinephrine are used to treat the vasodilator shock via increasing the SVR. SVR is measured using the formula {80*(Mean Arterial Pressure-Central Venous Pressure)/Cardiac Output}. In clinical practice, Transthoracic echocardiography (TTE) is a non-invasive and accurate modality for measuring the cardiac output (CO). A 57-year-old male patient was admitted to the ICU with the diagnosis of vasodilator shock induced by MALA. He had history of heavy alcohol consumption, type II Diabetes Mellitus on metformin, and hypertension on amlodipine.  Serial measurements of SVR were obtained aided by the TTE and vasopressors doses were titrated accordingly. High doses of Nor-epinephrine and Epinephrine up to 4 mcg/kg/min, and 4 mcg/min respectively were reached. In addition to the standard supportive medical treatment, ninety hours of continuous renal replacement therapy (CRRT) were provided to improve all of the lactic acidosis, renal impairment, and hyperkalemia. By the tenth day of the patient’s ICU stay both vasopressors were weaned off and the patient was discharged toward by the fifteenth day.

Biography

Ahmed Masoud has completed his MRCPCH and is currently a member of the Royal College of Paediatrics and Child Health, UK. He is currently a senior Paediatric CICU registrar at Aswan Heart Centre, Aswan, Egypt.      

Ahmed Sherif has completed his MSc. in Paediatrics and Neonatology degree from Ain Shams University, Egypt. He has also completed the MRCPCH exams and is currently a member of the Royal College of Paediatrics and Child Health, UK. He has been working at Aswan Heart Centre, Aswan, Egypt, but currently he is a senior PICU Clinical Fellow at Great Ormond Street Hospital, London, UK

Abstract

A 2 month old boy who presented with complete heart block and had a permanent pace maker inserted surgically at the age of 6 weeks was readmitted with mediastinitis and wound infection. His mother was diagnosed with systemic lupus erythematosis and he had a positive lab test for both anti Ro and anti La antibodies. He was noticed to be leucopenic and with further investigation, he was found to have severe combined immune deficiency (SCID) which was rarely reported to be associated with maternal systemic lupus and was more rare to present with congenital complete heart block. 

Biography

Han Hong, Chong graduated from University of Manchester Medical School at year 2013. He has completed his Intercollegiate Membership Examination of the Surgical Royal Colleges of Great Britain and Ireland (MRCS) at year 2017. He is currently a Specialist Trainee with Health Education East Midlands, United Kingdom and actively involved in case study & projects.

Abstract

Septic arthritis (SA) is a serious but rare joint pathology with an incidence of 4 – 10 / 100 000, with poly-articular SA comprising of 15% of those reported cases. Local cellulitis and endocarditis are known risk factors in developing SA, and there have been published case reports relating to endocarditis with poly-articular SA. However, to date, there has been no published cases correlating poly-articular SA with distance cellulitis or prosthetic heart valves. The author report a case of an immunocompetent gentleman who had a delayed presentation of bilateral knee SA following a revision surgery for aortic valve replacement. Post-operatively, he was diagnosed with a sternal wound infection four week from his operation, followed by bilateral knee pains four days later. He received combined antibiotic therapy and underwent multiple joint washouts. Further in-depth investigation unfortunately did not reveal the source of infection or type of microorganism. The origin of his bilateral SA remains unknown. 

Biography

Abstract

Background

GCA is the most common form of systemic vasculitis. Classically it affects the extracranial branches of the carotid arteries however it has the potential for large vessel involvement including the thoracic and abdominal aorta.

 

The Case:

 

We present the case of a 55-year old gentleman with a background of Ulcerative Colitis and associated HLA-B27 positive enteropathic arthritis.

He presented with a three week history of night sweats, unintentional weight loss and shortness of breath on exertion. His physical examination was unremarkable. He was found to have iron deficiency anemia. He underwent a thorough evaluation to out-rule an underlying neoplastic process. This included colonoscopy which revealed a >1cm polyp in the sigmoid colon for which he underwent polypectomy. Histology revealed an invasive moderately differentiated adenocarcinoma with evidence of lymphovascular invasion and a positive resection margin.

 

In light of this histology he underwent staging combined PET-CT scanning of the thorax, abdomen and pelvis. This revealed abnormal wall thickening and linear uptake throughout the length of the thoracic and abdominal aorta consistent with aortitis.

 

Giant cell arteritis was confirmed on subsequent temporal artery biopsy, the histology of which was remarkable for a very high number of giant cells (Despite lack of headache and visual symptoms). Mr X underwent a successful sub-total colectomy for management of his colonic pathology. He was subsequently commenced on Rituximab to manage his GCA, with resolution of symptoms.

 

Conclusion

This case highlights a less frequent presentation of GCA. In this case the diagnosis was found incidentally during workup for colorectal cancer.

We believe this case highlights that GCA should be considered in the differential for any patient 50 years or older presenting with unexplained fever, anemia or other constitutional symptoms or signs.

Biography

Dr. James Ryan is currently a surgical trainee on the core surgical trainee program in Ireland and has a keen interest in urology. He has attended the Urological Society of Australia and New Zealand annual meeting and the Irish society of Urology annual meeting and has had a poster presented at an international conference in Singapore. He is looking to further broaden his knowldege of urology and clinical surgery in general and progress to high specialist training in urology next year.

Abstract

Self-insertion of foreign bodies into the urethra concerns a wide variety of objects involving multiple procedures and surgical techniques. A 30 year old gentleman presented to the emergency department with mild suprapubic pain and difficulty voiding 5 days after inserting 2 small magnets into his urethra. A rigid cystoscopy was performed. The foreign bodies were attempted to be retrieved with a metallic basket however the basket was adhering to the magnet and unable to be advanced past the magnets. An endoloop was then passed down the urethra and visualized with a rigid cystoscope. The magnets were secured with an endoloop and successfully retrieved.  This is an exceptionally rare case of using an endoloop to remove a urethral foreign body (Up to 250 words)

Biography

Abstract

Background

 

Fixation of complex rib fractures and fractures associated with poor bone quality can pose a technically challenging operation.  We present a novel “plate on plate” technique to extend fixation across additional fractures encountered on a rib after an initial plate has already been placed and for ribs with multiple segmental fractures for a long distance without enough room to place separate plates. We have also used this technique to allow for extreme in-plane contouring when a single plate cannot be adequately contoured.

 

Case presentations

 

Our case report includes two 80-year-old females with medical history significant for osteoporosis who presented to the emergency room with multiple rib fractures including flail segments.  Each patient was taken to the operating room for surgical stabilization of their rib fractures after failure of non-operative management.  Many of the patients’ fractures were not visible on axial imaging due to poor bone quality or cartilaginous involvement.  Moreover, lower rib fractures involving the costal cartilages required extreme in-plane contouring beyond what we could achieve with a single plate with our available instrumentation. Both patients underwent a novel plate on plate technique to achieve extend fixation once an initial plate had been placed, for extremely long segments of rib with multiple segmental fractures as well as to achieve extreme in-plane contouring.

 

Conclusion

 

The plate on plate technique is a feasible way to obtain rib fracture stabilization in patients when additional fractures are encountered after initial plate placement as well as to address extreme in-plane contour challenges.

 

 

Biography

Dr. Khushali Jhaveri is doing her Internal medicine Residency from Georgetown University. She has done around 5 abstract/poster presentations in reputed international conferences. This case report is unique because the patient is Dr. Jhaveri herself. 

Abstract

A previously healthy 26 year old female presented with initial symptom of isolated neck pain.     She denied any headache, nausea, vomiting, blurry vision, numbness, tingling, muscle weakness or radiating pain. She denied fever, fatigue, joint pain, recent trauma, travel, sick contacts or changes in weight or appetite. No risk factors for HIV were identified.

 

Patient was afebrile with normal vital signs. On physical examination, isolated neck tenderness was noted without any redness or swelling. Range of motion was preserved. Nuchal rigidity, Kernig and Brudzinki’s sign were negative. Neuro exam revealed 5/5 motor strength in all extremities and intact sensation in all dermatomes. Normal reflexes were noted except left elbow and knee hyperreflexia.  Chest, cardiovascular, abdominal and extremities examination were unremarkable.

 

Initial laboratory examination including CBC with differential, inflammatory markers, renal and liver function were within normal limits. X-ray was done and was unremarkable. A trial of muscle relaxants was given. On non-resolution of symptoms, An MRI of the cervical spine was offered which revealed a heterogenous intramedullary lesion raising suspicion for an intramedullary neoplastic lesion. Screening of entire CNS was otherwise unremarkable.

 

To establish a specific diagnosis, patient underwent a posterior cervical laminectomy for tumor resection. Gross-total resection was not achieved due to drop in sensory potentials during intraoperative monitoring. Histopathological examination showed WHO grade 2 ependymoma.

 

Patient had no significant motor neurological impairment after surgery. However, significant sensory and proprioceptive loss was observed due to posterior spinal approach. She remains progression free at 9 months with MRI with stable residual tumor.

Tracks

Day2: December 3, 2019

Keynote Forum

Biography

Sam Arman graduated from University of Leeds Medical school in 2014. He has completed his Intercollegiate Membership Examination of the Surgical Royal Colleges of Great Britain and Ireland (MRCS) at year 2017. He is currently a Specialist Trainee with Health Education West Midlands, United Kingdom and actively involved in medical innovation, audit & research projects. 

Abstract

Introduction: Bochdalek hernia is a rare congenital diaphragmatic hernia normally diagnosed in the neonatal and postnatal period, with the diagnosis in adults being extremely rare.Eventration is an abdnormal elevation of the diaphragm resulting from failure of muscular development of part or all of the diaphragm. It is generally asymptomatic and is often found incidentally in adults.

Case: A 73 year-old male presented with complaints of worsening breathlessness over 1 year was found to have a  restrictive lung pattern on respiratory function testing. A diagnosis of eventration of the right diaphragm was made by chest x-ray and computed topography. The patient underwent elective video assisted thoracoscopy and thoractomy for surgical repair. At surgery, a diagnosis of Bochdalek hernia was made as the liver was found to have herniated into the thoracic cavity,  the defect was closed using a biological mesh.Patient has recovered well post-operatively.

Conclusion: We report a case of a right-sided Bochdalek hernia in an elderly male that was initially diagnosed as a right eventration of the diaphragm from radiological findings. Both disorders are rare in adults, however the use of VATs enabled appropriate diagnosis and definitive surgical repair.  

Biography

Mohammad Al-Jundi has completed medical school in Jordan University of Science and Technology in Jordan. He is currently a third year internal medicine resident in Georgetown University – Medstar Washington Hospital Center and will start fellowship in Endocrinology and Metabolism in the National Institute of Health on July 2019. His main interest in Diabetes, Thyroid and Pituitary disorder.

Abstract

Hypernatremia is defined as increase of serum sodium concentration more than 145 meq per liter. It is a very common electrolyte disturbance. Severe hypernatremia defined as sodium level higher than 160 that is associated with a mortality of 60%. We present a case of a 64 year old intellectually disabled nursing home resident who is admitted with severe hypernatremia (serum sodium level of 181 meq/dl). We will discuss the atypical presentation of this patient and review the highest reported sodium level in medical literature and analyze hypernatremia in extremes of age.

Biography

Abstract

Introduction: Fungal endocarditis is a rare and severe form of infectious endocarditis. The treatment strategy requires aggressive intervention once diagnosed as mortality rates are as high as 50%. Current treatment standards recommend both medical and surgical intervention. Chronic oral immunosuppressive therapy is an option for outpatient treatment, though the efficacy of this treatment needs further support. Chronic antibiotic use poses a risk for resistance and highlights the need for close outpatient management.

Case Report: A 75-year-old African American male with a history of mitral valve replacement secondary to candida glabrata endocarditis was found to have bio-prosthetic valve thickening with mitral annular calcification on transthoracic echocardiogram (TTE) after a fall in his home. He was taking Fluconazole 400 mg as chronic immunosuppressive therapy since his first infection 11 months prior. Documented susceptibility reports showed the following minimal inhibitory concentrations (MIC): Voriconazole 0.25 ug/ml, Ketoconazole 0.25 ug/ml, Amphotericin B 0.5 ug/ml, and Caspofungin 0.06 ug/ml. We were unable to obtain this patient's susceptibility report for Fluconazole, but assume due to his therapy regimen, the patient initially qualified for its use. Transesophageal echocardiogram (TEE) supported the patient’s TTE, showing two masses attached to the mitral valve leaflets measuring 1.4x0.8 cm and 0.8x0.6 cm. Serum fungitell measured B-D glucan levels > 500 and a third round of peripheral blood cultures grew Candida glabrata. The patient was started on Micafungin 150 mg and transferred to a nearby facility where a successful mitral valve replacement was completed. Compared to prior results, the new susceptibility report showed increased resistance to all medications (Voriconazole 4.0 ug/ml, Ketoconazole 2.0 ug/ml, Amphotericin B 1.0 ug/ml, and Caspofungin 0.25 ug/ml). Fluconazole MIC was extremely high, reaching 256 ug/mL.

Discussion: Use of long-term antibiotics poses a risk for increasing rates of resistance in already difficult infections. Chronic suppression therapy has low-quality evidence but is still strongly recommended in the Infectious Disease clinical guidelines. Proper dosing and susceptibility testing are necessary for accurate treatment of infectious endocarditis, though guidelines for MIC interpretation of these organism-drug combinations have not been established. It is important to also consider the role of patient non-compliance when medications are taken for long lengths of time.

Biography

Ruhma is a junior doctor at PAF Hospital, Islamabad. She received her MBBS degree from Army Medical College. She has passed United States medical licensing exams and has worked as a research scholar at Yale school of Medicine. Her research interests include developmental disabilities and neonatal medicine.

Abstract

Mucopolysaccharidosis type IV is an inherited, autosomal recessive, lysosomal storage disorder caused by deficiency of enzymes involved in the degradation of glycosaminoglycans (GAGs) which results in accumulation of keratan sulfate and chondroitin-6-sulfate in the tissues leading to pathological changes specifically at the bone and cartilage. The case of a 4 year old boy with Morquio syndrome is presented. Parents had a non-consanguineous marriage and no family history of a similar condition was observed on both sides. On examination, coarse facial features, short stature, widened wrists, pectus carinatum, kyphoscoliosis of the spine and genu valgum were noted. Motor examination revealed right leg stiffness. X-ray of the wrist showed irregular metaphysis of radius and ulna and sloping of the radius and ulna towards each other. The metacarpals were short and wide with pointed proximal ends. The carpal bones were small and irregular (figure 1). X-ray of the spine showed scoliosis, flattened vertebral bodies and central beaking of the vertebrae. Broadening of the anterior portion of the ribs was also seen (figure 2). A diagnosis of mucopolysaccharidosis type IV: Morquio syndrome was established based on the clinical examination and skeletal survey. Confirmation test were not done due to lack of infra structure. In conclusion Mucopolysaccharidosis type IV is a rare disorder with multisystem involvement. Since accurate diagnosis requires enzyme assay which is not available in underdeveloped countries, recognition of specific clinical signs and symptoms and radiographic findings are necessary to establish the diagnosis and provide optimum management plan.

Biography

Ruzimurodov Nodirjon has copmleted his masters degree from Tashkent medical academy. After graduation he has been working as Junior rsearcher in the Institute of Immunology and Human genomics of The Republic of Uzbekistan in tha depatrment of Cell Technology. He has published more than 7 papers.

Abstract

Background: Currently, the only possible way to cure patients with diabetes is to transplant the pancreas or its cells, which is a very effective way to achieve and maintain long-term physiological control of blood glucose levels, but due to various risks (rejection) associated with performing a surgical procedure, this method is rarely used.

Materials and methods: Xenotransplantation was performed by 186 DM patients aged 13 to 59 years. Of these, 106 were transplanted in newborn lambs, 80 from piglets.

Results: The dynamics of clinical manifestations of diabetes was studied separately in patients who received insulin before transplantation in a dose of less than or more than 40 units. As the examination of patients with implants of the islet cells of pancreas showed, within 9 months after the transplantation practically all disappeared clinical manifestations of the diabetes itself and its complications. Only 3 patients showed mild complaints of dry mouth, sometimes pain in the limbs.

Consequently, after the transplantation of islet cells of pancreas both lambs and pigs, it is possible to significantly reduce the dose of exogenous insulin administered to a patient with DM. So at 9 and 12 months after the transplant, the reduction in the dose of insulin received by the patients was statically unreliable.

Conclusion: Thus, summing up the clinical results of islet cell transplantation along with the achievements, we noted that the problem bears in itself many more questions that await their resolution. 

Biography

Ismailov Muzaffar has completed his bachelor degree and enrolled in a master’s degree in surgery. I This is the thesis of my first theses in international conferebce. I think that you will support my interests in science and allow me to publish in your collection.

Abstract

Introduction: Acute calculous cholecystitis is a very common disease with several areas of uncertainty. The World Society for Emergency Surgery has developed extensive guidelines for covering gray areas.

Material and methods: In an emergency surgery department of the 1st Tashkent city hospital, a retrospective analysis of case histories of 75 patients.

Results: We divided the patients into three groups which almost equally converges with the stages. And so, 31 patients entered the first group with non-destructive forms of acute cholecystitis and cholestasis syndrome like hyperbilirubinemia, biliary hypertension according to ultrasound. The presence of the above symptoms and signs indicated the presence of a mechanical obstacle to the outflow of bile. The second group consisted of 27 patients who had, in addition to those Patients who were in the second and third group, an endoscopic papillosphincterotomy, which was carried out in various forms like cannulation, a combined form, non-cannulation. The length of the incision major papulla produced on an individual goal for each patient. Littoextraction was performed in 31 patients, including lithotripsy in 2 patients.

One of the most important type of treatment - cholecystectomy. 26 traditional cholecystectomies, 39 laparoscopic cholecistetomas, and 2 conversions were performed.

Conclusions: To establish the cause of obstructive a comprehensive clinical and instrumental examination is necessary and this will help improve the quality of life of the patient in the immediate postoperative period and in remote periods.

Biography

Dr. Hani obtained his basic medical degree from Jessenius Faculty of Medicine – Comenius University in Bratislava on June 23rd, 1999. In March 2004, he got Diploma of the Membership of The Royal Collage of Surgeon in Ireland (AFRCSI) (MRCSI), in addition to the Certificate of Arab Board of Surgery (CABS) in February, 2008. He finished his training in Surgical Oncology Fellowship program at University of Toronto, in February, 2011. Moreover he had Laparoscopic HPB Fellowship from Southampton University hospitals, NHS trust, in November, 2013.

       He is the head of the hepato-biliary-pancres unit of King Hamad University Hospital, a premier research organization and teaching hospital for the Royal College of Surgeons Ireland, Bahrain Branch. He has published many papers in reputed journals.

Abstract

Introduction:

      Acute cholangitis is a clinical syndrome characterized by fever, jaundice, and abdominal pain that develops as a result of stasis and infection in the biliary tract. The most frequent causes of biliary obstruction are biliary calculi, benign biliary stricture, and malignancy.

 

Case presentation:

      Here we report a case presented with septic shock and acute ascending cholangitis on top of an altered anatomy in the form of disruption of the head and Wirsung duct of pancreas, complete avulsion of the CBD at the ampulla of vater and deformed duodenal bulb after an old road traffic accident sustained thirty five years back. Initial resuscitation, antibiotic therapy with urgent decompression have been done. Definitive surgery has been performed in the form of dismantling of prior cholecystojejunostomy, exploration and resection of common bile duct with cholecystectomy and Roux-en-Y hepaticojejunostomy with adhesiolysis.

 

Conclusions:

• Definitive surgery remained the mainstay of treatment for extrahepatic biliary and pancreatic trauma to prevent future life threatening complications.

• MDT approach is the optimal choice for dealing with critically ill patients.

• Utilization of the full capabilities of endoscopic and interventional radiology services deemed mandatory for urgent and timely management.

Biography

Afsaneh Motevalli Haghi has completed her PhD from Tehran University of Medical Sciences. She is assisstant professor of the department of Medical Parasitology and Mycology, School of Public Health. She has published more than 40 papers in reputed journals and has been serving as a member of  Iranian Scientific Association of Parasitology

Abstract

BACKGROUND: The incidence of fever and hemolysis is not rare, but these manifestation with some organism (dots) on RBCs is extremely rare and very dangerous.
CASE REPORT: A 45 years old man was admitted in hospital with fever and chills and confusion. He had a Past medical history including depression and psychological problem from 6 months ago also, social history were contact with hamster 5 years ago and contact with cats recently. Moreover, in Lab tests the following results were observed: WBC: 6500, Hb: 6.5, plt: 255000, retic ↑, LDH ↑, LFT: normal. CXR: normal, abdominal and pelvic sonography: normal.

CONCLUSIONS: According to PBS findings the patient treated with IV levofloxacin. Fever and chills resolved after 5 days and treatment changed to oral doxycycline. The patient was afebrile and the weekly PBS showed the organism on blood smear. After 4 week the patient returned to hospital with loss of consciousness and seizure. LP: WBC: 0, RBC: 800, Protein: 90, glc: 60, Brain MRI: normal.

Treatment changed to IV levofloxacin. The patient become awake and alert but the retic was 10% and the PBS showed 3% parasitemia. Treatment changed to doxycycline + gentamycin+ clindamycin the parasitemia decreased to 0.1% but after 3 weeks increased again. Finally the patient was cured using co-trimoxazole for three months.

Keywords: hemolysis, fever, loss of consciousness, unknown organism

Biography

Dr Duaa Abduljabbar has completed her medical degree from Arabian Gulf university in the Kingdom of Bahrain in 2013. She is currently completing her final year in the Saudi Board residency program. She has completed part A and B in Membership of the Royal Collage of Physicians (MRCP). Currenlty she is working as a senior resident in internal medicine department in King Hamad University Hospital.

Abstract

A 14-year-old female presented to the gastroenterology clinic due to incidental finding of deranged liver function tests.

She is a known case of diabetes mellitus (DM) and hypothyroidism on treatment since 5 years with lantus 38 units at night , novorapid 20 units with meals, and levothyroxine 100 mcg daily.

The diagnosis of autoimmune hepatitis was made based on hepatocellular picture in liver enzymes elevation (ALP 377 , ALT 424 , AST 451 and GGT 118), ESR 63 mm/hr, ANA positive centromere pattern 191 u/ml, Anti smooth muscle antibody 640 , immunoglobulin G 3945 mg/dL. However Anti liver-Kidney microsomal antibody was in insignificant level.
Abdominal US showed  coarse hepatic echotexture having stippled pattern with increased periportal echogenicity, with possibility of hepatitis.

A review of her diagnosed DM and hypothyroidism with further investigations was done and showed uncontrolled type 1DM confirmed by high HbA1C , and seropositivity towards anti-glutamic acid decarboxylase (332 IU/ml, 6+++).

Immune thyroid disease diagnoses was made based on positive antithyroid peroxidase antibody of >1300 u/ml, at the time thyroid function tests were normal as patient was already of treatment.

 The case showed rare combination of three distinct autoimmune disases starting at young age. The patient was followed regularly in the clinic, the condition improved with normalization of LFT with the use of steroids and immunosuppression.

 

Biography

SOUGOU Pascal Emery is a doctor Lieutenant-Colonel of the gabonese military health service. He obtained a doctorate in medecine at the faculty of medecine of the university Omar Bongo in Libreville, and specialist in anesthesia and rescucitation obtained at the faculty of medicine of the university Cheikh Anta Diop of Dakar. He was the second chief of intensive care unit at the Army Training Hospital Omar BONGO ONDIMBA. Dr SOUGOU is now the Chief of emergency at the Army Training Hospital of Akanda in Libreville and Chief medical officer of Mobile Emergency and Rescucitation Service of Army (SMURA)

Abstract

The traumatic wounds of inferior vena cava are relatively rare and are at the origin of a high morbidity-mortality. Diagnosis is often difficult hence the interest of imaging.

We report an observation of a patient suffering from a trauma penetrating the abdomen caused a wound of inferior vena cava.

Admitted in shock, persistent despite initial resuscitation, he benefits from a first laparotomy explorer without initial radiological exploration due to this hemodynamic instability. It is highlighted a retroperitoneal hematoma that is respected.

However, the persistense of this state of shock, motivates the realisation of an abdominal scanner that objective an acute hematoma covering the Inferior Vena Cava to the convergence of the primitive iliac veins.

Stabilization will only occur after secondary reintervention which will allow the repair of the inferior vena cava wound by simple phleborraphie.

The evolution was favorable after 17 days in intensive care.

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