Ahmad Zarour

• MD, FRCSI, FACS
• Consultant at Hamad Medical Corporation

Introduction : Acute cholecystitis (AC) is a prevalent condition in emergency departments (EDs). Standard care involves early laparoscopic cholecystectomy; however, in cases of delayed presentation, high surgical risk, or during situations like the COVID-19 pandemic, percutaneous cholecystostomy (PC) serves as an alternative management strategy. Th...

Objective: Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. It is commonly encountered during surgical practice as the cause of the patient’s presentation or as an incidental finding during other unrelated procedures. This study aimed to evaluate the frequency of Meckel’s diverticulum in our clinical practi...

Key Clinical Message Vigilant intraoperative inspection is crucial during gallbladder surgery to detect any abnormal tissue including the rare pyloric gland adenomas, which can be easily missed. Thorough examination and removal of unusual lymph nodes or thickened tissues are essential to prevent the risk of malignant transformation and ensure compr...

Background/Objectives: Coronary artery bypass graft (CABG) is associated with inflammation and complications, potentially leading to prolonged ICU and hospital stays. Omega-3 PUFA has anti-inflammatory properties, thought to potentially reduce complications in CABG patients. This study aims to systematically review and meta-analyze the impact of pe...

Post-traumatic stress disorder (PTSD) is a debilitating psychological condition that may develop in certain individuals following exposure to life-threatening or traumatic events. Distressing symptoms, including flashbacks, are characterized by disrupted stress responses, fear, anxiety, avoidance tendencies, and disturbances in sleep patterns. The...

This paper aims to provide an in-depth review of the specific outcomes associated with omega-3 polyunsaturated fatty acids (PUFAs), focusing on their purported effects on post-surgical complications in trauma patients. A comprehensive investigation of omega-3 polyunsaturated fatty acids was conducted until February 2023 using the PubMed database. S...

Background: The world has witnessed one of the largest pandemics, dubbed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of December 2020, the USA alone reported 98,948 cases of coronavirus disease 2019 (COVID-19) infection during pregnancy, with 109 related maternal deaths. Current evidence suggests that unvaccinated pregnant wom...

Background: Internal hernias are infrequent, yet serious, medical conditions with potentially severe consequences. An internal hernia resulting from an Appendices epiploicae (AE) ring is an especially rare cause, with a mere nine documented instances worldwide. Case report: This report presents the case of a 58-year-old male who suffered from an in...

Background: Acute Appendicitis (AA) is the most common abdominal surgical emergency. It requires proper management to decrease mortality and morbidity. Clinical scoring systems for diagnosing AA aimed to decrease the use of radiological scans and the rate of negative appendectomies (NA). We aim to assess the adult appendicitis score (AAS) in the d...

Aim Secondary peritonitis is a common serious surgical condition that has a significant rate of morbidity and mortality. Postoperative abdominal abscesses are considered a common complication. The purpose of this study is to analyze how the type of peritonitis, whether general or localized, can influence the formation of postoperative abdominal abs...

Purpose This research aims to study whether the time of day impacts the outcome of laparoscopic appendectomy. Peri/post-operative data including type of surgery, operating room time, length of stay, re-hospitalization rates, and short/long term morbidity and mortality were assembled and analyzed. Methods A retrospective review of all patient's cha...

Background: Acute cholangitis (AC) is a life-threatening condition with a mortality risk of 8%–10%. Despite no gold standard for diagnosis, Charcot's triad was introduced to diagnose AC. However, the triad had a low sensitivity (50%–70%). Recently, Tokyo guidelines (TG) for the diagnosis of AC gained international recognition for their excellent di...

Background & Aims The BioNTech‐Pfizer vaccine is the only vaccine offered to children among all available vaccines. However, limited evidence is available about the clinical outcomes of COVID‐19 vaccines, especially among children and adolescents. This review offers a comprehensive and up‐to‐date overview of the BioNTech‐Pfizer vaccine's current in...

Background/objective Acute appendicitis (AA) is one of the most common surgical emergencies that require a proper diagnosis to avoid a negative outcome in the case of missed or delayed diagnosis. Our study aims to assess the diagnostic power of the Alvarado score and the prediction of the severity of acute appendicitis in correlation to intraoperat...

Gallstone disease in high-risk patients presents a management dilemma as cholecystectomy is often not performed due to their co-morbidities. Alternatively, such patients can be managed by percutaneous removal of gallstones. To date, there is paucity of high-quality evidence addressing the safety and efficacy of percutaneous cholecystolithotomy in h...

Background: The BioNTech-Pfizer vaccine is the only vaccine offered to children among all available vaccines. However, limited evidence is available about the clinical outcomes of COVID-19 vaccines, especially among children and adolescents. This review offers a comprehensive and up-to-date overview of the BioNTech-Pfizer vaccine’s current informat...

Background: Acute cholangitis (AC) is an acute inflammation and infection of the biliary tract, a potentially life-threatening infection, which is usually associated with biliary tree obstruction and impairment of bile flow from the liver to the duodenum. AC is classified by severity from mild, moderate to severe infection (grade I to III, respect...

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Su...

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and...

Background: The predictive role of platelet to lymphocyte ratio (P/LR) in patients with perforated peptic ulcer (PPU) is not well-studied. We aimed to investigate the association between the P/LR ratio and the hospital length of stay (HLOS) for surgically treated PPU. Method: This is a retrospective observational study for surgically treated adu...

Aeroportia is the presence of gas in the portal vein. It is considered an ominous radiological sign with poor outcomes. Historically, it was associated with bowel necrosis, and surgery was mandated in all cases. Herein, we present a challenging case of portal venous gas and its management. An 87-year-old male patient, with multiple co-morbidities,...

Acute pancreatitis is a common condition that has been the cause of extreme suffering, morbidity, and vast expenditure to the health care system worldwide. The incidence of 5-30 cases per 100,000 has been reported and is said to be increasing recently .One of the most common form of this disease is 'biliary pancreatitis' which is thought to result...

Jejunoileal diverticulosis (JID) is a rare and nonspecific symptomatic disease. It is usually an acquired condition associated with false diverticula and integrated with colonic diverticulosis which can be diagnosed incidentally or later with complications. A sixty-nine-year-old male presented with sudden onset generalized abdominal pain. Computed...

The prevalence of transmesocolic hernias, a subtype of internal hernias (IHs), is generally low. Its clinical consequences, including strangulation, ischemia and even death, however, necessitate awareness. IHs are classified as congenital or acquired as resulting from surgery, trauma or intraperitoneal inflammation. This is a case of a 37-year-old...

Objective: To investigate the presentation, management and outcomes of left and right-sided traumatic diaphragmatic injury (TDI) in a single level I trauma center. Methods: This cross-sectional study was conducted during a 7-year period from 2008 to 2015 in a level I trauma center in Qatar. We included all the patients who presented with TDIs du...

The descriptive identification and interpretation of liver pathology continue to raise debate, especially for trainees and junior physicians. There is wide diversity in the description of liver segmentation with sometimes contradictory terminology between French and American literature. Attempts were made to create a unified nomenclature that simpl...

Buried bumper syndrome (BBS) is a rare complication developed after percutaneous endo-scopic gastrostomy (PEG). We report a case of a 38-year-old male patient who sustained severe traumatic brain injury that was complicated with early BBS after PEG tube insertion. On admission, bedside PEG was performed, and 7 days later the patient developed signs...

Background: Porto-mesenteric venous thrombosis (PMVT) is an infrequent but severe surgical complication developing in patients who underwent laparoscopic bariatric surgery (sleeve gastrectomy). Herein, we describe the clinical presentation, management, and outcome of 3 rare cases of PMVT after laparoscopic sleeve gastrectomy (LSG), successfully tr...

Background: Blunt chest trauma (BCT) poses significant morbidity and mortality worldwide. Objectives: We investigated the clinical presentation and outcome of BCT related to road traffic accidents (RTA). Patients and methods: A retrospective observational analysis for patients who sustained BCT secondary to RTA in terms of motor vehicle crash...

Background: Spontaneous rupture of the urinary bladder (SRUB) secondary to alcohol intoxication is an uncommon presentation with high morbidity and mortality. Herein, we reported a rare case of spontaneous atraumatic rupture of the urinary bladder due to alcohol intoxication. Case report: A 45-year-old Sri Lankan man presented with drowsiness, d...

A structured research programme is one of the main pillars of a trauma care system. Despite the high rate of injury-related mortalities, especially road traffic accidents, in Qatar, little consideration has been given to research in trauma. This review aimed to analyse research publications on the subject of trauma published from Qatar and to discu...

Background: The incidence of abdominal trauma is still underreported from the Arab Middle-East. We aimed to evaluate the incidence, causes, clinical presentation and outcome of abdominal trauma patients in a newly established trauma center. Methods: A retrospective analysis was conducted at the only level I trauma centre in Qatar for patients admit...

BACKGROUND Portal vein thrombosis (PVT) is an infrequent clinical condition usually associated with multiple etiological factors and diseases. In some cases, PVT remains undiagnosed and is incidentally detected during routine examination for a known etiology. CASE REPORT Here, we present a rare case of portal vein thrombosis associated with acute c...

Background: The approach for diagnosis and management of blunt splenic injury (BSI) has been considerably shifted towards non-operative management (NOM). We aimed to review the current practice for the evaluation, diagnosis and management of BSI. Methods: A traditional narrative literature review was carried out using PubMed, MEDLINE and Google sch...

Objective: We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP). Methods: A retrospective analysis was conducted at the only level 1 national trauma center in Qatar for all adult patients(≥18 years old) who received MTP (≥10...

Introduction: Motor vehicle crashes (MVC) are the leading cause of morbidity and mortality in Qatar among young age population. We aimed to evaluate the impact of seatbelt use on the injury pattern and outcome of vehicle occupants involved in MVC. Materials and methods: It is a retrospective analysis of all trauma patients who sustained MVC-related...

Introduction: We aimed to study time-based mortality in traumatic chest injury (TCI) over a 3-year period in a fast developing country. Materials and methods: We conducted a retrospective observational study for TCI patients admitted between 2008 and 2010 in Qatar.Patients were classified according to time of death postinjury into 3 groups (group1:...

Introduction: The Alcohol Screening and Brief Intervention [ASBI] program for trauma patients is a standard component of Level I Trauma Centers and previous analysis of our ASBI identified challenges and opportunities for such an intervention in the Middle East. This study will describe the process evaluation of a new ASBI program in a Trauma Cente...

Introduction: Pelvic fracture is a significant injury, commonly associated with other injuries and carries potential serious outcomes. We aimed to study the incidence, associated injuries and outcome of pelvic fracture according to the mechanism of traumatic injury (MOI). Materials and methods: It is a retrospective descriptive analysis of all case...

Introduction: Restraint systems (seatbelts and airbags) are important tools that improve vehicle occupant’s safety during motor vehicle crashes (MVC). We aimed to identify the pattern and impact of the utilization of passenger restraint systems on the outcomes of MVCs victims in Qatar. Methods: A retrospective study was conducted for all admitted p...

Objectives: We aimed to analyze the pattern and outcome of traumatic neck injury (TNI) in a small population. Materials and Methods: It is a retrospective analysis of all TNI patients who were admitted to the trauma center between 2008 and 2012. Patients’ demographics, details of TNI, associated injuries, hospital course, and mortality were analyze...

Introduction Motor vehicle crashes (MVC) are the leading cause of morbidity and mortality across the globe. Seat belt is an important protective device which improves occupant’s safety during MVC. Herein, we aimed to evaluate the impact of protective devices used (seatbelt/airbag) on the injury pattern and outcome of vehicle occupants involved in M...

Introduction: The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is mainly used to distinguish necrotizing fasciitis (NF) from severe soft tissue infections, however it is rarely used as a prognostic indictor. We aimed to evaluate the role of LRINEC score as a predictor in patients with NF. Materials and methods: We conducted a...

Background. management and outcomes of occult hemopneumothorax in blunt trauma patients who required mechanical ventilation are not well studied. We aimed to study patients with occult hemopneumothorax on mechanical ventilation who could be carefully managed without tube thoracostomy. Methods. Chest trauma patients with occult hemopneumothorax who...

Background. The management and outcomes of occult hemopneumothorax in blunt trauma patients who required mechanical ventilation are not well studied. We aimed to study patients with occult hemopneumothorax on mechanical ventilation who could be carefully managed without tube thoracostomy. Methods. Chest trauma patients with occult hemopneumothorax...

Background: Bispectral index (BIS) monitoring in multiple trauma patients has become a common practice in monitoring the sedation levels. We aimed to assess the utility of BIS in the trauma intensive care unit (ICU). Methods: A prospective observational study was conducted in the trauma ICU at Hamad General Hospital in Qatar between 2011 and 201...

Background The mechanism and outcome of traumatic abdominal injury (TAI) varies worldwide. Moreover, data comparing TAIs in each abdominal compartment are lacking. We aimed to assess from the academic point of view, TAI based on its anatomical compartments. Patients & methods We conducted a retrospective study for TAI patients between 2008 and 201...

Rollover crashes (ROCs) are responsible for almost a third of all highway vehicle occupant fatalities. Although ROCs are common and serious mechanism of injury, ROCs are under‑reported. To analyze the causes, mechanism, impact and prevention of ROCs, we reviewed the literature between 1984 and 2013. By utilizing the search engines PubMed, MEDLIN...

Background: Data on time-based trauma mortality (TTM) patterns in developing countries are lacking. OBJECTIVE:Our objective was to analyze the TTM in a newly established trauma center. METHODS:A retrospective analysis of all trauma-related mortality between 2010 and 2012 was conducted in Qatar. Based on the time of injury, deceased cases were categ...

Background: Trauma remains one of the leading causes of morbidity and mortality worldwide. Generally, the incidence of traumatic injuries is disproportionately high in males. However, trauma in females is underreported. Aim: To study the epidemiology and outcome of different mechanisms and types of traumatic injuries in women. Methods: We cond...

Background: Traumatic brain injury (TBI) is a common cause of morbidity and mortality worldwide. It is difficult to estimate the real incidence of traumatic subarachnoid hemorrhage (TSAH). Although TSAH after trauma is associated with poor prognoses, the impact of mechanism of injury (MOI) and the pathophysiology remains unknown. We hypothesized t...

Pneumomediastinum (PM) is mainly an atypical finding among traumatic neck or thoracic injury patients. Moreover, PM secondary to isolated orbital floor fracture remains a rare event which is infrequently associated with severe complications such as mediastinitis, airway obstruction and pneumothorax. Herein, we report an atypical case of mediastinal...

Trauma represents a global public health concern with an estimated 5 million deaths annually. Moreover, the incidence of blunt traumatic injuries (BTI) particularly road traffic accidents (RTAs) and workplace-related injuries are rising throughout the world-wide. We aimed to review the epidemiology and prevention of BTI, in the Arab Middle East. A...

Traumatic workplace-related injuries (WRIs) carry a substantial negative impact on the public health worldwide. We aimed to study the incidence and outcomes of WRIs in Qatar. We conducted occupational injury surveillance for all WRI patients between 2010 and 2012. A total of 5152 patients were admitted to the level 1 trauma unit in Qatar, of which...

To develop a scoring tool based on clinical and radiological findings for early diagnosis and intervention in hemodynamically stable patients with traumatic bowel and mesenteric injury (TBMI) without obvious solid organ injury (SOI). A retrospective analysis was conducted for all traumatic abdominal injury patients in Qatar from 2008 to 2011. Data...

Objectives. To study the effect of prehospital intubation (PHI) on survival of patients with isolated severe traumatic brain injury (ISTBI). Method. Retrospective analyses of all intubated patients with ISTBI between 2008 and 2011 were studied. Comparison was made between those who were intubated in the PHI versus in the trauma resuscitation unit (...

Qatar is a rapidly developing country in which expatriate workers constitute the majority of population. Also, Qatar is an example of right-sided road driving convention (RDC) country. The aim of our study is to analyse the traffic-related pedestrian injuries (TRPI) amongst expatriates in relation to RDC. A retrospective analysis of prospectively c...

Objectives To develop a scoring tool based on clinical and radiological findings for early diagnosis and intervention in hemodynamically stable patients with traumatic bowel and mesenteric injury (TBMI) without obvious solid organ injury (SOI). Methods A retrospective analysis was conducted for all traumatic abdominal injury patients in Qatar from...

Optimal management of patients with intra-abdominal free fluid found on computed tomography (CT) scan without solid organ injury remains controversial. The purpose of this study was to determine the significance of CT scan findings of free fluid in the management of blunt abdominal trauma patients who otherwise have no indications for laparotomy. D...

Introduction: There is a growing debate surrounding the optimal ratio of FFP:RBC in massive transfusion protocols [MTP] for patients with massive traumatic hemorrhage. The discussion has evolved to include the time at which the appropriate ratio is achieved and its effect on mortality, both within and beyond 4 hours. This report aimed to describe t...

Blunt bowel and mesenteric injury (BBMI) is frequently a difficult diagnosis at initial presentation. We aimed to study the predictors for early diagnosis and outcomes in patients with BBMI. Data were collected retrospectively from the database registry between January 2008 and December 2011 in the only Level I trauma unit in Qatar. Patients with B...

Background: The incidence of recreation related-injuries (RRI) among the physically active population is increasing. This study aimed to analyse frequency and characteristics of RRI in Qatar. Methods: A retrospective chart review was conducted for all patients with head injuries who sustained a RRI and were admitted to the trauma unit between 20...

Background: Overall traumatic brain injury (TBI) incidence and related death rates vary across different age groups. Objectives. To evaluate the incidence, causes, and outcome of TBI in adolescents and young adult population in Qatar. Method: This was a retrospective review of all TBIs admitted to the trauma center between January 2008 and Decem...

BACKGROUND: Traumatic diaphragmatic injury (TDI) is usually associated with multiple injuries. We aimed to evaluate the patterns, associated injuries, and predictors of in-hospital mortality of patients with TDI. METHODS: The trauma registry from a Primary Adult Resource Center for Trauma was queried for patients admitted with a TDI from January 19...

Traumatic diaphragmatic injury (TDI) is usually associated with multiple injuries. We aimed to evaluate the patterns, associated injuries, and predictors of in-hospital mortality of patients with TDI. The trauma registry from a Primary Adult Resource Center for Trauma was queried for patients admitted with a TDI from January 1995 to December 2009....

Background Percutaneous dilatational tracheostomy (PDT) is a routine surgical procedure for critically ill patients who require prolonged ventilatory support. Methods We conducted a retrospective cohort study of all PDTs performed at the adult Trauma Intensive Care Unit (TICU) of Hamad Medical Corporation in Doha, Qatar, from January 2009 through S...

Background: This study aimed to determine the incidence and outcome of post-traumatic (PT) intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) after the advances in haemostatic resuscitation. Methods: This is a prospective cohort study from January 2009-December 2011 involving patients with PT haemorrhagic shock. Patients...

Background A quarter of trauma-related deaths are attributable to traumatic chest injury (TCI). Objective To outline the pattern and outcome of TCI in a rapidly developing country among different age groups. Methods We conducted a retrospective observational study for patients who sustained TCI and admitted between January 2008 and December 2010 to...

Objectives. To assess the standard practice of care of surgeons regarding surgical antibiotic prophylaxis, to identify gaps, and to set recommendations. Methods. A retrospective analysis of data obtained from different surgical units in a single center in Qatar over a 3-month period in 2012. A total of 101 patients who underwent surgery and followe...

Multiple organ dysfunction syndrome (MODS) is a systemic, dysfunctional inflammatory response that requires long intensive care unit (ICU) stay. It is characterized with high mortality rate depending on the number of organs involved. It has been recognized that organ failure does not occur as an all-or-none rule, but rather a range of organ dysfunc...

All terrain vehicle (ATV) use is increasing at a rapid pace in settings without proper safety regulations. Aim: To define injury patterns, impairments, and outcomes among patients injured in ATV crashes; to determine prevalence of protective equipment use; and to define the potential role of injury prevention in addressing the problem. Methods: Dur...

Traffic-related pedestrian injuries (TRPI) are vulnerable to road users. In this study, we aimed to evaluate the demographic pattern of injury and outcome of TRPI. Patients with TRPI admitted between November 2007 and March 2010 to the only level 1 trauma centre in Qatar were included. A retrospective analysis was based on medical records and Emerg...

Background: Traumatic chest injury (TCI) constitutes quarter of trauma-related deaths worldwide. Objective: To identify the pattern and outcome of TCI in Qatar in relation to age. Methods: Data were collected from all patients who sustained TCI between January 2008 and December 2010 in Qatar. Patients were classified and analyzed in 3 age groups (g...

Background: In the State of Qatar, the majority of workers are expatriates from different ethnicity and culture. Most of them are liable to pedestrian motor vehicle crashes (MVC). We sought to understand the anatomy, time and date of injuries amongst expat workers in relation to their country of origin, culture and traditions. Methods: Retrospectiv...

Essentials of Bowel Anastomosis is intended to be a comprehensive yet concise reference work covering modern techniques of bowel surgery, describing both hand-sewn and stapled anastomoses in two settings, conventional open surgery, and minimally invasive surgery. This text covers the entire spectrum of gastrointestinal anastomosis, including anatom...

Cardiac injuries are classified as blunt and penetrating injuries. In both the injuries, the major issue is missing the diagnosis and high mortality. Blunt cardiac injuries (BCI) are much more common than penetrating injuries. Aiming at a better understanding of BCI, we searched the literature from January 1847 to January 2012 by using MEDLINE and...