Tartous, SANA_ A new unique surgery is registered for the health sector in Syria in general and for the medical staff in Al-Basel Hospital in the coastal province of Tartous in particular.<\/p>\n
The British Medical Research Journal “BMC Surgery” published a research paper entitled \u201ca rare serious case of retroperitoneal paraganglioma misdiagnosed as duodenal gastrointestinal stromal tumor\u201d.<\/p>\n
Surgeon Shawky Mahmoud, who performed the operation with the help of a specialized medical staff, gave a detailed explanation of this case.<\/p>\n
A 41- year- old lady presented with mild left flank discomfort. She had experienced recurrent anxiety attacks accompanied by palpitations and headache which were managed previously as panic attacks.<\/p>\n
Radiologic investigations showed a retroperitoneal mass that located anteromedial to the left kidney, separated from the left adrenal gland and adherent to the 4th duodenal segment, he explained.<\/p>\n
During admission, her vital signs showed slight elevation of blood thus 24-h urine metanephrine and normetanephrine were requested where the results revealed normal values.<\/p>\n
Upper gastrointestinal endoscopy failed to pass beyond the 3th duodenal segment and showed no pathologic evidence. According to her findings, a diagnosis of duodenal gastrointestinal stromal tumor (GIST) was suspected.<\/p>\n
During laparotomy, crises of hypertension and tachycardia followed by severe hypotension made the resection of the misdiagnosed mass very tricky.<\/p>\n
Immunohistochemical staining studies confirmed the diagnosis of paraganglioma.<\/p>\n
Paraganglioma is a life threatening disease and should always be considered as a differential diagnosis of asymptomatic retroperitoneal mass.<\/p>\n
The aim of our study is to present a challenging case of an undiagnosed retroperitoneal paraganglioma and to alarm our colleagues from such troubles.<\/p>\n
The surgery lasted for about five and a half hours, according to the Surgeon Mahmoud, noting to the serious complications that accompanied the work of medical team due to hypertensive crisis followed by hypotension and cardiac arrhythmia as a result of contact with the tumor mass.<\/p>\n
He added that this necessitated performing the operation without touching the tumor.<\/p>\n
2000\u2009ml of blood lost and six blood units were transfused to the patient during the surgery, Dr. Mahmoud said.<\/p>\n
The patient was observed in intensive care unit for 24\u2009h and her vital signs stayed stable. Postoperative course was uneventful. The patient was discharged home on postoperative day six.<\/p>\n
He said that this surgery is qualitative, rare and very dangerous and we wanted to share it at a high level locally and globally.<\/p>\n
It is the fourth time that a medical research by the hospital staff has been published in the most important international scientific journals.<\/p>\n
Despite the economic blockade and the limited capabilities available, we were able to perform a qualitative and rare surgery, Dr. Mahmoud said.<\/p>\n
Director of the General Authority for Al-Basil Hospital, Dr. Iskandar Ammar, confirmed that several scientific researchers have been published in the name of \u00a0Al-Basil hospital in Tartous at the world level, the most recent of which was in the aforementioned British magazine.<\/p>\n
Gh.A.Hassoun<\/p>\n
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