Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
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16-AUGUST-2009 AHMAD RIYAD AL-HEET 27 YEARS
CONDITION AFTER GUN SHOOT TO THE CAUDA EQUINA 4 MONTHS AGO.
Anamnesis:
The patient was operated by
me twice for gun shoot, the last was
29-April-2009.
Removal of big shrapnels was achieved at that
time.
The patient continued to
improve, but he was all the time complaining lf
pain in the right lower limb and the perianal
region.
Transcoccygeal injection of
marcain 5 cc 0.5% with diprofos 2 vials was done
without G.A. The pain in the right lower limb
and the perianal region disappeared. Myelography
was done between L3-4 and about 8 cc of
Omnipaque was used to enforce dissection of the
scar to reach the CSF above the lesion. There
was a pocket which was also noticed .
The patient was sent to
perform CT-Myelography.
Comments
The case is interesting from
the clinical aspect: he has agonizing cauda
equina pain, which confirm that the structure is
functioning.
There are still small tiny
shrapnels, which impossible to remove them. They
with the contused rootlets of the cauda equina
are the generators of pain. The anatomical
structures must be preserved and to manipulate,
so as to keep them anatomically and ease the
pain of the patient.
Please! wait for 3-5 min till the
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Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
