Islam Fawzy Mohamed Omar
Hepato-biliary-pancreas Surgery Unit, Surgery Department, King Hamad University Hospital, Bahrain.
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.