Le Journal médical libanais. The Lebanese medical journal
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Review Case Reports
[Retroperitoneal cystic lymphangiomas in adults: four case reports and review of the literature].
Retroperitoneal location of cystic lymphangiomas in adult patients is rare. Their clinical presentation is not specific. ⋯ These tumors must be distinguished from mesenteric cysts which are more frequent and can degenerate. The authors report four cases of retroperitoneal cystic lymphangioma with a literature review.
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Thyrotoxic hypokalemic periodic paralysis (TPP)--a rare complication of thyrotoxicosis and a medical emergency--is characterized by recurrent episodes of muscle weakness and hypokalemia associated with hyperthyroidism. We report a case of TPP in a 38-year-old white Lebanese male. The patient suffered from severe muscle weakness of the upper and lower limbs. ⋯ His paralysis resolved with IV potassium. The patient was treated with propranolol and radioactive iodine with complete remission of the hyperthyroidism and the paralysis. A discussion of the clinical and pathophysiological features and treatment of TPP is presented.
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Palliative care (PC) is defined by the World Health Organization as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness..." In Lebanon, PC is new to the health care field and as such very little is known about type of services offered and the preparedness of health care professionals to provide PC. The purpose of this study is to determine the knowledge, attitudes, and practices of physicians and nurses towards PC in Lebanon, and to assess the need and model for service delivery. ⋯ The response rate was 32%; 51% for nurses and 13% for physicians. Around 93% of nurses and 96% of physicians were able to identify the goals of PC. The majority (94% to 99%) believes terminally ill patients and their families should be informed of the diagnosis and prognosis. Only 19% percent of physicians routinely inform terminally ill patients about their diagnosis. Around 100% of the respondents believe that PC services need to be developed in Lebanon warranting the need for continuing education in this field.
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Herniation of abdominal contents through the diaphragm has been described in a variety of diaphragmatic defects and may occur secondary to diaphragmatic injury, either traumatic or iatrogenic. The aim of this study is to report a case of gastro-pleural fistula in a patient with traumatic diaphragmatic hernia. ⋯ An 18-year-old male patient, with a past history of blunt abdominal trauma, presented with epigastric abdominal pain and dyspnea. A thoracoabdominal CT scan revealed the presence of a herniated portion of the stomach with suspected perforation and free fluid in the left hemithorax. An exploratory laparotomy was performed. The esophageal hiatus was normal but a 4 cm rent was discovered in the posterior leaf of the left hemidiaphragm. Passing through the defect was the fundus of the stomach with evidence of perforation in left pleural space causing empyema. Resection of the herniated portion of the stomach and running suture of the gastric body were performed. Diaphragm was directly repaired without graft. Finally, a chest tube was placed in the left hemithorax. Postoperative course was uneventful and he recovered without complications. He was discharged from hospital 13 days after surgery.