Sala Abdalla

• BSc MBBS FRCS (Eng) FRCS (Gen Surg)
• Consultant at London North West University Healthcare NHS Trust

Aims Health tourism for cosmetic surgeries such as abdominoplasty and liposuction are increasing at alarming frequency. The complications from such surgeries can be catastrophic. We present two cases of abdominoplasties performed overseas that resulted in life-changing post-operative complications that were managed in the UK. Methods Patient A: 48...

We present a case of a woman in her 70s who arrived in the emergency department with signs of small-bowel obstruction. CT scanning revealed acute cholecystitis with a cholecystoduodenal fistula, pneumobilia and small-bowel obstruction possibly secondary to gallstone ileus although no radio-opaque gallstones were seen. The patient underwent an emerg...

Stump appendicitis, a rare postoperative complication of appendicectomy, is inflammation of the remnant appendix tissue due to incomplete removal of the appendix at the index operation. Due to a past surgical history of appendicectomy, there is often a diagnostic delay. This delay can result in increased morbidity and mortality for patients. This s...

Background Laparoscopic cholecystectomy is the mainstay for treatment of symptomatic gallstones and its associated complications. Emergency cholecystectomy rates in the United Kingdom (UK) remain low despite NICE guidelines recommendations to offer surgery within 7 days for acute cholecystitis and index cholecystectomy for mild gallstone pancreatit...

Background The incidence and severity of presentation of cholelithiasis or its complications increases with increasing age. Higher risks of morbidity, longer hospital stay, and mortality are the potential challenges to this emergency procedure in this cohort. There is little UK based data citing outcomes of emergency surgery in this group of popula...

The routine use of prophylactic antibiotics for the prevention of surgical site infection is no longer recommended in all types of elective ventral hernia repairs, according to national and international guidelines.NICE recommends that prophylactic antibiotics are given only in clean surgeries that involve the use of a prothesis or implant. The Bri...

Introduction De Garengeot's hernia is a rare subtype of femoral hernia which contains the vermiform appendix. Acute appendicitis in a femoral hernia is even more unusual, accounting for 0.08% - 0.13% of all cases of femoral hernias. Case presentation A 91-year-old woman was referred with a painful, cellulitic right groin mass. A computed tomograph...

Pancreatic pseudocyst is a widely recognised local complication following acute pancreatitis. Typically occurring more than four weeks after acute pancreatitis, a pseudocyst is a mature, encapsulated collection found within the peripancreatic tissues manifesting as abdominal pain, structural compression, gastroparesis, sepsis and organ dysfunction....

Background Eye tracking technology may provide the basis of a novel, objective technical skill assessment in surgery. Past research has showed differences in the gaze patterns between expert and novice surgeons. The aim of this study was to investigate the relationship between gaze behaviors and technical skill during laparoscopic cholecystectomy a...

https://www.rcseng.ac.uk/news-and-events/blog/a-reflection-on-the-plight-of-the-bame-community-during-the-pandemic/

A Meckel's diverticulum (MD) is a congenital abnormality of the gastrointestinal tract which is estimated to be present in 2% of the population. Gastrointestinal stromal tumours (GISTs) are rare, soft-tissue tumours which represent 0.1%–3% of all gastrointestinal tumours. The association of an MD and a GIST is extremely unusual since fewer than 3%...

Harold Ellis, Sala Abdalla Taylor & Francis, 10 Dec 2018 - 266 pages Written in a personal and engaging style, this book provides a fascinating and informative introduction to the development of surgery through the ages. It describes the key advances in surgery through the ages, from primitive techniques such as trepanning, some of the gruesome bu...

Abstract The optimal timing of loop ileostomy reversal remains largely unknown, but evidence that delayed ileostomy closure may increase postoperative complication rates is increasing. PURPOSE: Retrospective research was conducted to compare outcomes between patients who had early (<6 months) or late (>6 months) loop ileostomy closure. METHODS: Rec...

Access to adequate health services is a universal right for individuals and lack of it can have adverse consequences. The elective hernia repair rate in Ghana remains low and a considerable number of inguinal hernias still present as emergencies. Operation hernia is a charitable, UK-based organization that supports the healthcare infrastructure in...

A common post-operative complication of many operations is seroma formation, which, while generally considered to be relatively minor, can be problematic for patients and a drain on healthcare resources due to the need for frequent outpatient reviews and repeated aspirations. Several mechanisms have been implicated in the development of seromas, an...

Access to adequate health services is a universal right for individuals and lack of it can have adverse consequences. Ghana has a relatively low physician-to-population density and this limits the provision of essential interventions such as elective surgery. The elective hernia repair rate in Ghana remains low and a considerable number of inguinal...

While colonoscopy is generally regarded as a safe procedure, colonic perforation can occur and the risk of this is higher when interventional procedures are undertaken. The presentation may be acute or delayed depending on the extent of the perforation. Extracolonic gas following colonic perforation can migrate to several body compartments that are...

Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterine cavity. Although it is a leading cause of chronic pelvic pain and infertility, its clinical presentation can vary, resulting in diagnostic and therapeutic challenges. Extrapelvic endometriosis is particularly difficult to diagnose owing to its ability to mimi...

A 54-year-old female with a large, eviscerated incisional hernia underwent emergency repair of the hernia with Strattice mesh and Components Separation. She had undergone two previous ventral hernia repairs which were complicated by mesh and wound infections. There was significant skin loss and a large fascial defect that necessitated reinforcement...

Surgical site infections (SSIs) are a drain on the healthcare economy. A recent development for the primary prevention of wound infections is the use of negative pressure wound therapy (NPWT) on closed wounds. The Prevena™ Incision Management System (KCI USA, Inc., San Antonio, TX) is a new NPWT designed for application on closed surgical incisions...

Desmoid tumours can cause significant morbidity and mortality owing to their locally infiltrative behaviour. Management of such cases can be complex and the collaboration of personnel from different disciplines is paramount for the delivery of care of these patients.

Introduction: Desmoid tumours (DTs) are rare, soft tissue tumours which account for 0.03% of all neoplasms. They are characteristically locally invasive but do not metastasize. There is frequent association with females of reproductive age, a history of abdominal surgery or trauma and a family history of fibromatoses. Intra-abdominal DTs are infre...

Extra-abdominal complications of pancreatitis such as pancreaticopleural fistulae are rare. A pancreaticopleural fistula occurs when inflammation of the pancreas and pancreatic ductal disruption lead to leakage of secretions through a fistulous tract into the thorax. The underlying aetiology in the majority of cases is alcohol-induced chronic pancr...

Gastrointestinal (GI) metastases from primary breast carcinoma are rare but more common in invasive lobular carcinoma than invasive ductal carcinoma. The symptoms may be non-specific and the presentation can occur many years after the initial primary breast carcinoma. Radiological and endoscopic findings can be difficult to distinguish from inflamm...

Introduction: Pathological nipple discharge is usually of benign aetiology but cancer may be the underlying cause in up to 20% of the presentations. The diagnostic value of discharge cytology and significance of presence of blood remains a topic of interest. Our study sets out to review the distribution of histopathology and diagnostic application...

Calot's triangle is an anatomical landmark of special value in cholecystectomy. First described by Jean-François Calot as an "isosceles" triangle in his doctoral thesis in 1891, this anatomical space requires careful dissection before the ligation and division of the cystic artery and cystic duct during cholecystectomy. The modern definition of the...

The Halsted radical mastectomy that prevailed in the first half of the 20th century derived its scientific basis from the 'lymphatic permeation theory' of William Sampson Handley, an Honorary Senior Consulting Surgeon and former Vice President of the Royal College of Surgeons. Through his pioneering work in the cancer research laboratories at the M...

Review and evaluate the prevalence and severity of individual symptoms in patients with chronic rhinosinusitis (CRS) with or without nasal polyposis. Retrospective analysis of data from the National Comparative Audit of Surgery for Nasal Polyposis and CRS, carried out across 87 hospitals in England and Wales between 2000 and 2001. A total of 2573 p...

Objective To evaluate the current practice variation in Sinonasal surgery and to ascertain the underlying factors contributing to such wide variation Methods Retrospective multicentre observational study. Participants: 1101 patients undergoing endonasal sinus surgery at four randomly selected NHS Trusts during 2005 and 2006 Results The four NHS Tru...

A period of time spent in the dissecting room as an anatomy demonstrator used to be a well-trodden path for the majority of surgical trainees. Dr Sala Abdalla, a current anatomy demonstrator at King's College London, explains the reasons why this remains a valuable exercise.

Poor trunk extensor endurance is implicated in low back pain, less is known regarding contributions of different regions of the erector spinae to maximum torque production particularly after fatigue. This study examines torque and electromyographic (EMG) activity following a maximal voluntary contraction (MVC) hold in these muscles. 16 students (9...