Category: Blog

Knee ligament injuries are among the most frequent injuries in sports and daily activities. They range from minor strains to complete tears that may require surgery and months of rehabilitation. Knowing how these injuries happen, what symptoms to look for, and the best treatment options can make a big difference in recovery and prevention. 

Understanding the Anatomy of the Knee 

The knee is one of the largest and most complex joints in the body. It connects the thigh bone (femur) to the shin bone (tibia) and is supported by four main ligaments: 

• Anterior Cruciate Ligament (ACL): Prevents the tibia from sliding forward. 

• Posterior Cruciate Ligament (PCL): Prevents the tibia from sliding backward. 

• Medial Collateral Ligament (MCL): Provides stability on the inner side of the knee. 

• Lateral Collateral Ligament (LCL): Provides stability on the outer side of the knee. 

Together, these ligaments keep the knee stable during movement and absorb stress from activity. 

Different Types of Knee Ligament Injuries 

ACL Injury 

The ACL is the most commonly injured ligament. It’s often torn during sports that involve sudden stops, pivots, or awkward landings. 

PCL Injury 

The PCL is injured less frequently. It usually happens in car accidents or contact sports when the shin is forced backward. 

MCL Injury 

The MCL is commonly injured by a direct blow to the outside of the knee, pushing it inward. This is frequent in football, rugby, and skiing. 

LCL Injury 

The LCL is the least commonly injured ligament. Damage occurs when the inside of the knee is hit, forcing the joint outward. 

Causes of Knee Ligament Tears 

Knee ligament injuries are often caused by sudden, forceful movements that strain the knee beyond its normal range of motion. Some common causes include: 

• Sudden changes in direction: Quick pivots, shifts, or sudden stops in sports can lead to a ligament tear, particularly in high-intensity activities like soccer, basketball, and skiing. 

• Improper landings: Landing incorrectly after a jump can put excess stress on the ligaments, causing them to stretch or tear. 

• Direct impacts: Contact sports such as football and rugby often involve direct blows to the knee, which can damage ligaments. 

• Twisting or overstretching: Actions that cause the knee to twist awkwardly or stretch too far can result in tears, especially in the anterior cruciate ligament (ACL). 

Symptoms of Knee Ligament Tears 

The severity of symptoms can vary depending on the ligament affected and the extent of the injury. Some common symptoms include: 

• Pain: This can range from mild to severe, often occurring immediately after the injury. Pain tends to be sharp and intense, especially with movement. 

• Swelling: Swelling usually occurs within hours of the injury, and the knee may become noticeably larger and more tender. 

• Instability: You may experience a feeling of the knee “giving way” or a loss of stability, making it difficult to walk or stand. 

• Reduced range of motion: The knee may feel stiff, and bending or straightening it could be painful or difficult. 

Essential Recovery Steps and Treatments 

Treatment for knee ligament tears varies depending on the severity of the injury. Here’s an overview of the recovery steps and treatments available at Burjeel Royal Hospital Asharej: 

1. Initial Treatment (RICE Protocol): 
   For mild injuries or sprains, the first step in treatment is the RICE method: 

• Rest: Avoid putting weight on the knee to prevent further damage. 

• Ice: Apply ice packs to reduce swelling and manage pain. 

• Compression: Use an elastic bandage or brace to support the knee and limit swelling. 

• Elevation: Keep the knee elevated to help reduce swelling. 

2. Physical Therapy: 
   For moderate injuries, physical therapy is essential to regain strength and mobility. A physical therapist will guide you through exercises that focus on strengthening the muscles around the knee, such as the hamstrings and quadriceps, to help stabilize the joint. 

3. Bracing and Activity Modification: 
   In cases of moderate to severe tears, a knee brace may be used to provide support during movement. Activity modifications are also recommended to prevent further strain on the ligament while it heals. 

4. Surgical Intervention: 
   For severe tears, particularly of the ACL, surgical intervention may be required. This is often followed by a lengthy rehabilitation period to restore the knee’s functionality. At Burjeel Royal Hospital Asharej, our orthopedic surgeons specialize in minimally invasive knee surgeries, such as ACL reconstruction, to ensure a quicker recovery with less risk of complications. 

5. Rehabilitation: 
   Following surgery, rehabilitation is critical. A structured physical therapy program will help restore strength, flexibility, and stability to the knee. This phase of recovery may take several months, with most patients returning to normal activities within 6 to 12 months, depending on the severity of the tear. 

Treatments Offered at Burjeel Royal Hospital Asharej 

At Burjeel Royal Hospital Asharej, we offer advanced, personalized treatments for knee ligament injuries: 

• Consultation with Expert Orthopedic Surgeons: Our team of orthopedic surgeons specializes in knee injuries and provides tailored treatment plans based on your unique condition. 

• Advanced Imaging and Diagnostics: We utilize state-of-the-art imaging techniques, such as MRI and X-rays, to accurately diagnose the extent of the injury and create an effective treatment strategy. 

• Minimally Invasive Surgery: We perform minimally invasive surgeries that reduce recovery time and minimize scarring, allowing for a faster return to activity. 

• Comprehensive Rehabilitation Programs: Our physical therapists offer customized rehabilitation programs to ensure full recovery, improve range of motion, and strengthen the muscles around the knee. 

Prevention Strategies 

While not every injury can be avoided, you can lower your risk by: 

• Strengthening muscles around the knee (especially hamstrings and quadriceps) 

• Improving flexibility and balance 

• Using proper sports techniques 

• Wearing appropriate shoes and protective gear 

• Avoiding sudden, uncontrolled movements 

Frequently Asked Questions 

Conclusion 

Knee ligament tears can significantly impact your mobility, but with prompt treatment and proper rehabilitation, most people can fully recover and return to their normal activities. If you suspect you have a knee ligament injury, don’t wait. Contact Burjeel Royal Hospital Asharej to schedule a consultation with our specialized orthopedic doctors and begin your path to recovery today. 

Shoulder pain is a common issue that can disrupt work, hobbies, and even restful sleep. By understanding the causes of shoulder pain, you can take proactive steps to manage symptoms, prevent worsening, and find lasting relief. This guide explores the most frequent culprits—ranging from injuries and arthritis to shoulder bursitis. 

Table of Contents 

1. Introduction to Shoulder Pain 

2. Common Shoulder Injuries 

1. Dislocations, Sprains, and Strains 

2. Frozen Shoulder and Rotator Cuff Tears 

3. Arthritis in the Shoulder 

4. Understanding Shoulder Bursitis 

5. FAQs 

6. Conclusion 

Introduction to Shoulder Pain 

The shoulder is a complex joint with an exceptional range of motion. While this flexibility allows us to reach, lift, and rotate with ease, it also makes the shoulder more vulnerable to injuries and degenerative conditions. Identifying the root causes of shoulder pain is the first step toward proper treatment and long-term relief. 

Common Shoulder Injuries 

Because of its mobility, the shoulder is susceptible to both sudden trauma and chronic overuse injuries. 

Dislocations, Sprains, and Strains 

Falls, quick movements, or accidents often lead to shoulder dislocations, sprains, or strains. These injuries typically result in: 

• Sudden, sharp pain 

• Swelling and inflammation 

• Limited mobility and difficulty lifting the arm 

Frozen Shoulder and Rotator Cuff Tears 

Some shoulder problems develop more gradually. Frozen shoulder (adhesive capsulitis) causes stiffness and reduced range of motion, often lasting months. Meanwhile, rotator cuff tears—either partial or complete—occur due to repetitive strain, aging, or acute injury. Both can significantly limit daily activities if left untreated. 

Arthritis in the Shoulder 

Arthritis in the shoulder is a common cause of chronic pain, especially in individuals over 50. However, it can also result from prior injuries or overuse earlier in life. Key symptoms include: 

• Deep, aching shoulder pain 

• Swelling around the joint 

• Stiffness, particularly in the morning or after inactivity 

While arthritis cannot be reversed, treatments focus on managing symptoms and maintaining joint function. 

Understanding Shoulder Bursitis 

Shoulder bursitis occurs when the bursa—small, fluid-filled sacs that cushion the joint—becomes inflamed. This often develops from repetitive motion or direct trauma. Symptoms include: 

• Tenderness at the top of the shoulder 

• Swelling and warmth in the area 

• Pain that worsens with overhead activity 

Proper rest, anti-inflammatory measures, and physical therapy can usually help resolve the condition. 

FAQs 

What are the most common causes of shoulder pain? 

The leading causes include acute injuries (dislocations, sprains, strains), chronic conditions such as frozen shoulder or rotator cuff tears, arthritis, and shoulder bursitis. 

How is shoulder pain diagnosed? 

Doctors use a combination of medical history, physical examination, and imaging tests like X-rays, ultrasound, or MRI to determine the underlying cause. 

How is shoulder pain treated? 

Treatment varies depending on the cause. Options range from rest, physiotherapy, and medications to injections or surgery in severe cases. 

Conclusion 

Knowing what’s behind your shoulder pain is the first step toward lasting relief. From sports injuries to joint conditions, there are effective treatment options to improve strength and flexibility. The orthopedic and physiotherapy experts at Burjeel Hospital Abu Dhabi combine advanced diagnostics with expert physiotherapy to ensure a faster, more complete recovery. Don’t let shoulder pain hold you back—get the right care today.

Book your consultation now and start your journey toward pain-free movement.

ACL injuries are among the most common sports-related injuries, affecting athletes of all levels—from recreational players to professionals. A torn ACL doesn’t just sideline you from your favorite activity; it also demands time, patience, and the right care to recover fully. This comprehensive guide explains everything you need to know about ACL injuries, from how they happen to how you can rehabilitate and return to your sport. 

What is an ACL Injury? 

The Anterior Cruciate Ligament (ACL) is one of four major ligaments in your knee. Its primary role is to stabilize the knee joint and control back-and-forth motion. 

An ACL injury, often called a torn ACL, occurs when the ligament is overstretched or torn due to sudden stress. These injuries are especially common in high-impact sports that require quick pivots, jumps, and direction changes. 

Causes of ACL Injury 

Most ACL injuries happen during sports or physical activities that involve: 

• Sudden stops or rapid changes in direction 

• Jumping and landing awkwardly 

• Direct collisions with another player 

• Twisting the knee beyond its normal range of motion 

Sports with higher ACL injury rates include soccer, basketball, football, and skiing. 

Risk Factors for ACL Injury 

While anyone can suffer an ACL tear, certain factors increase the risk: 

• Gender differences: Female athletes are statistically more likely to experience ACL injuries due to anatomical and hormonal factors. 

• Improper footwear: Shoes that don’t provide proper support increase instability. 

• Playing surface conditions: Uneven or poorly maintained fields raise injury risk. 

• Previous knee injuries: Past ligament or meniscus issues can make the ACL more vulnerable. 

Symptoms of ACL Injury 

Signs of an ACL tear are usually immediate and difficult to ignore. Common symptoms include: 

• A loud “pop” at the moment of injury 

• Sudden, severe knee pain 

• Rapid swelling within hours 

• Instability or the knee “giving way” 

• Difficulty bearing weight on the injured leg 

Diagnosing an ACL Injury 

If an ACL tear is suspected, a healthcare professional will carry out: 

• Physical examination: Tests like the Lachman test or pivot-shift test check for knee stability. 

• Imaging tests: 

• X-ray to rule out bone fractures. 

• MRI to confirm ligament damage and evaluate associated injuries like meniscus tears. 

Accurate diagnosis is essential to creating the right treatment plan. 

Treatment Options for ACL Injury 

Treatment varies depending on the severity of the injury, the patient’s age, and activity level. 

Non-Surgical Options 

• Rest, ice, compression, and elevation (RICE method) 

• Physical therapy to restore strength and mobility 

• Bracing to stabilize the knee during activity 

Surgical Options 

For athletes and highly active individuals, ACL reconstruction surgery is often recommended. This involves replacing the torn ligament with a graft from the patient’s own body (autograft) or a donor (allograft). 

ACL Rehabilitation 

Rehabilitation is the most critical part of ACL recovery—whether surgery is performed or not. The process typically involves: 

• Phase 1: Reducing pain and swelling, regaining basic motion 

• Phase 2: Strengthening exercises for quadriceps and hamstrings 

• Phase 3: Balance and stability training 

• Phase 4: Sport-specific drills and functional exercises 

• Phase 5: Gradual return to play, usually 6–12 months after injury (post-surgery) 

Commitment to rehab is the single most important factor in regaining full knee function. 

FAQs about ACL Injury 

Q: How long does it take to recover from an ACL injury? 
A: Recovery time varies, but after surgery, most athletes return to sport within 6–12 months. Non-surgical cases may recover faster, depending on severity. 

Q: Is surgery always necessary for an ACL injury? 
A: Not always. Less active individuals may benefit from physiotherapy alone, but surgery is usually advised for athletes or those whose lifestyles demand high knee stability. 

Q: Can ACL injuries be prevented? 
A: While not all injuries can be prevented, you can reduce your risk by strengthening leg muscles, practicing proper landing techniques, using supportive footwear, and training on safe surfaces. 

Conclusion 

Understanding an ACL injury is the first step toward prevention and complete recovery. If you suspect a tear, seek prompt medical attention. At Burjeel Hospital, Abu Dhabi, our orthopedic and rehabilitation experts provide advanced diagnosis, treatment, and physiotherapy to help you regain full mobility and confidence.

Take care of your knees—they’re the foundation of every step, jump, and stride. 

Our Experts

Introduction 

Living with Lipedema can be both painful and life-limiting. A 37-year-old patient came to Burjeel Hospital after years of struggling with massive swelling in both lower limbs, causing severe pain and restricting mobility. Despite seeking help from multiple physicians, her condition persisted until a specialized vascular surgery team diagnosed her with Grade 3 Lipedema. 

Understanding Lipedema 

Lipedema is a chronic medical condition marked by abnormal fat accumulation in the lower body, often misdiagnosed as obesity or lymphedema. In advanced stages, it severely impacts mobility and quality of life. 

Treatment Approach 

At Burjeel Hospital, the patient underwent suction-assisted liposuction—the only proven effective treatment for Lipedema. Non-surgical approaches such as compression therapy and diet changes offer limited relief but do not resolve the underlying issue. 

Surgical Success 

The first stage of her treatment involved a 4.5-hour procedure where 10 liters of pathological fat were removed from her thighs and calves. The surgery was performed with precision through multiple small incisions, ensuring minimal scarring and optimal outcomes. 

Recovery and Results 

Post-surgery, the patient enrolled in a comprehensive rehabilitation program, including manual lymphatic drainage and physiotherapy. Within weeks, she experienced significant pain relief and regained her mobility. Grateful for the holistic care, she shared her satisfaction with the multidisciplinary team at Burjeel Holdings. 

Conclusion 

This case demonstrates how advanced surgical care, rehabilitation, and patient-centered treatment can restore not only physical function but also confidence and quality of life for Lipedema patients. 

Our Doctors

When a 32-year-old man arrived at Burjeel Medical City seeking a second opinion for his mysterious symptoms, he had already been diagnosed with Cushing’s disease at another facility. However, his case would prove to be one of the most challenging endocrine disorders to diagnose and treat – a condition so rare that it affects only 1-2 people per million worldwide.

The Journey to Accurate Diagnosis

The patient’s health concerns began subtly with decreased libido, a symptom that might seem minor but was actually the first indicator of a serious hormonal imbalance. Medical evaluation revealed hypogonadotropic hypogonadism, a condition where the body doesn’t produce enough reproductive hormones.

As his condition progressed, more concerning symptoms emerged:

• Significant weight gain with central obesity
• Purple stretch marks (striae) appearing on his trunk
• Development of “moon face” – a characteristic rounded facial appearance
• Formation of a “buffalo hump” – fatty deposits between the shoulders

These physical changes, combined with his hormonal abnormalities, painted a clear picture of Cushing’s disease – a rare condition caused by excess cortisol production.

The Diagnostic Mystery: When Advanced Imaging Fails

Despite having classic symptoms of Cushing’s disease, the patient’s case presented an extraordinary challenge. Laboratory tests confirmed the diagnosis with elevated hormone levels:

• 24-hour urine free cortisol: 371 mcg (significantly elevated)
• Morning serum cortisol: 24.72 (above normal range)
• ACTH levels: 64.3 (indicating pituitary origin)

However, both 1.5 Tesla and 3 Tesla MRI scans showed no visible pituitary tumor. This presented what medical experts call “MRI-Negative Cushing Disease” – a condition that represents approximately 25% of all Cushing’s disease cases and creates significant diagnostic and treatment challenges.

Advanced Diagnostic Techniques: The Role of Multidisciplinary Care

Recognizing the complexity of the case, Burjeel Medical City’s team implemented a comprehensive multidisciplinary approach involving:

Endocrine Tumor Board Consultation

The case was presented to a specialized tumor board comprising endocrinologists, neurosurgeons, interventional radiologists, and pathologists. This collaborative approach ensures that every aspect of the patient’s condition is carefully evaluated.

Inferior Petrosal Sinus Sampling (IPSS)

When standard imaging fails to locate a pituitary tumor, IPSS becomes the gold standard for tumor localization. This sophisticated procedure involves:

• Catheter insertion into the inferior petrosal sinuses
• Direct hormone sampling from blood vessels draining the pituitary gland
• Precise tumor localization by comparing hormone levels from different sides

In this patient’s case, IPSS revealed significantly elevated ACTH levels in the left inferior petrosal sinus, confirming the tumor’s location on the left side of the pituitary gland.

Cutting-Edge Surgical Intervention: Minimally Invasive Endoscopic Approach

Dr. Mohamed A. Elzoghby, Consultant Neurosurgeon at Burjeel Medical City, led the surgical team in performing a minimally invasive endoscopic transsphenoidal resection. This advanced technique offers several advantages over traditional open surgery:

The Oldfield’s Technique

This specialized surgical approach involves:

• Extracapsular dissection to identify the tumor’s pseudo-capsule
• Precise tumor removal while preserving healthy pituitary tissue
• Minimal tissue disruption compared to traditional methods

Endoscopic Advantages

• Panoramic visualization of the surgical field
• High magnification for precise tumor identification
• Improved tumor detection even when invisible on MRI
• Faster recovery compared to open procedures

The Expert Surgical Team

This complex case required the expertise of multiple specialists:

Remarkable Recovery and Patient Outcomes

The surgery was a complete success, with several positive indicators:

Immediate Surgical Success

• Complete tumor removal achieved using microsurgical techniques
• Preservation of normal pituitary function
• No intraoperative complications

Biochemical Remission

Post-operatively, the patient’s cortisol levels dropped below 0.8 µg/dL, confirming complete remission of Cushing’s disease. This dramatic improvement indicated successful removal of the ACTH-secreting adenoma.

Rapid Recovery

• Started on cortisol replacement therapy as a temporary measure
• Discharged after only 3 days without complications
• Excellent recovery at 6-week follow-up

Understanding the Challenges of MRI-Negative Cushing Disease

This case highlights several important aspects of rare endocrine disorders:

Diagnostic Complexity

• 25% of Cushing’s cases are MRI-negative
• Delayed diagnosis often occurs due to imaging limitations
• Specialized testing like IPSS is crucial for proper localization

Treatment Challenges

• Extensive pituitary exploration may be required during surgery
• Advanced visualization techniques improve tumor identification
• Multidisciplinary expertise is essential for optimal outcomes

Why Burjeel Medical City Excels in Complex Endocrine Surgery

This successful case demonstrates several key strengths of Burjeel’s approach:

Advanced Technology

• High-resolution 3 Tesla MRI for detailed imaging
• State-of-the-art endoscopic equipment for minimally invasive surgery
• Intraoperative imaging capabilities for real-time guidance

Specialized Expertise

• Experienced neurosurgeons trained in pituitary surgery
• Interventional radiologists skilled in IPSS procedures
• Endocrinologists specializing in rare hormonal disorders

Multidisciplinary Care

• Tumor board discussions ensure comprehensive treatment planning
• Coordinated care across multiple specialties
• Patient-centered approach focused on optimal outcomes

Patient Testimonial: Excellence in Care

The patient expressed profound gratitude for his treatment experience:

“I would like to express my deepest gratitude to Dr. Mohamed A. Elzoghby and his incredible team for the exceptional care I received throughout my recent surgery. Dr. Elzoghby’s professionalism, precision, and calm confidence immediately put me at ease… What stood out to me most was not just his surgical expertise, but his genuine care and attentiveness.”

The Future of Rare Endocrine Disorder Treatment

This case represents the evolution of medical care for complex endocrine conditions:

Precision Medicine

• Targeted diagnostic approaches for rare conditions
• Minimally invasive surgical techniques reduce patient morbidity
• Personalized treatment plans based on individual patient needs

Technology Integration

• Advanced imaging continues to improve tumor detection
• Robotic assistance may further enhance surgical precision
• Real-time monitoring improves surgical outcomes

Conclusion: Hope for Patients with Rare Conditions

The successful treatment of MRI-negative Cushing disease at Burjeel Medical City demonstrates that even the most challenging medical conditions can be effectively managed with:

• Specialized expertise in rare endocrine disorders
• Advanced diagnostic techniques like IPSS
• Minimally invasive surgical approaches
• Comprehensive multidisciplinary care
• State-of-the-art medical technology

For patients facing similar challenges, this case provides hope that expert medical teams can achieve excellent outcomes even in the most complex situations.

Workplace eye injuries can happen in an instant, but the consequences can be life-altering. A recent case at Burjeel Hospital demonstrates how quick thinking, advanced surgical techniques, and specialized expertise can save both vision and prevent serious complications when dealing with penetrating orbital injuries.

A Workplace Accident with Serious Consequences

A 43-year-old construction worker was rushed to Burjeel Hospital’s emergency department after sustaining a severe eye injury while working with metal equipment. A metallic object had penetrated his left eye, causing immediate bleeding and excruciating pain.

The injury occurred during routine work activities, highlighting the importance of proper safety equipment and the unpredictable nature of workplace accidents involving the delicate structures around the eye.

Critical Assessment and Advanced Imaging

Upon arrival, Dr. Ann Divya Jacob, Specialist in Ophthalmology, conducted a thorough clinical examination that revealed a 7mm external wound on the medial aspect of the left eye. While concerning, the external wound didn’t reveal the full extent of the injury.

Advanced CT imaging was immediately ordered to assess the internal damage and locate the foreign object. The results were both surprising and alarming:

• A dense, metallic foreign body measuring 15 x 15 mm
• Located in the extraconal space near the insertion of the medial rectus muscle
• No immediate damage to the optic nerve or other critical structures

The Surgical Challenge: Precision and Safety

The diagnosis was clear: penetrating orbital injury with retained metallic foreign body. However, the treatment required exceptional surgical skill and careful planning.

Key Challenges Faced:

1. Size of the foreign object – At 15x15mm, it was significantly larger than typical foreign bodies
2. Location near critical structures – Close proximity to the medial rectus muscle
3. Risk of posterior displacement – Any surgical error could push the object toward the optic nerve
4. Preventing muscle damage – Maintaining extraocular muscle function was crucial

Innovative Surgical Technique Under Local Anesthesia

Dr. Pulak Puneet, Specialist Anesthetist, administered local anesthesia to keep the patient comfortable while maintaining their ability to cooperate during the procedure.

The surgical approach required innovative thinking when standard ophthalmic instruments proved inadequate:

The Solution:

• Standard ophthalmic instruments were too small and couldn’t provide secure grip
• Large curved artery forceps were selected for their superior grasping capability
• Single-piece extraction through the original entry wound
• Careful technique to prevent posterior displacement toward the optic nerve

Advanced Surgical Facilities and Equipment

This complex procedure was performed in Burjeel’s state-of-the-art operating theater equipped with:

• High-resolution surgical microscopes for precise visualization
• Advanced imaging integration for real-time guidance
• Specialized ophthalmic instruments and backup equipment
• Emergency protocols for potential complications

Successful Outcome and Vision Preservation

The foreign body was successfully extracted in one piece without causing additional damage to surrounding structures. Post-extraction testing included a forced duction test to ensure the extraocular muscles remained intact and functional.

Key Success Factors:

• Immediate medical attention prevented infection and further damage
• Advanced diagnostic imaging provided crucial pre-surgical planning
• Experienced surgical team with expertise in complex orbital procedures
• Innovative problem-solving when standard instruments proved inadequate

The Importance of Emergency Orbital Surgery

This case highlights several critical aspects of emergency eye care:

Timing is Critical

• Prompt medical attention prevents complications
• Delayed treatment can lead to infection, scarring, or vision loss
• Emergency surgery may be required to preserve sight

Specialized Expertise Required

• Orbital anatomy is complex and requires specialized knowledge
• Experience with foreign body removal is essential
• Understanding of both ophthalmology and emergency surgery

Advanced Imaging Essential

• CT scans provide detailed visualization of foreign objects
• Pre-surgical planning reduces complications
• Real-time imaging guidance improves outcomes

Prevention and Workplace Safety

While this case had a successful outcome, it serves as an important reminder about workplace eye safety:

• Always wear appropriate safety eyewear when working with metal tools
• Ensure proper safety protocols are followed in industrial settings
• Seek immediate medical attention for any eye injury, regardless of severity
• Regular safety training can prevent many workplace injuries

Why Choose Burjeel for Emergency Eye Care?

Burjeel Hospital’s ophthalmology department offers:

• 24/7 emergency eye care services
• Advanced diagnostic imaging including high-resolution CT
• Experienced orbital surgeons trained in complex procedures
• State-of-the-art surgical facilities with latest technology
• Comprehensive follow-up care for optimal recovery

Our multidisciplinary approach ensures that patients receive the highest level of care for even the most challenging eye emergencies.

Recovery and Follow-up Care

The patient’s recovery was smooth and uncomplicated. Follow-up examinations confirmed:

• Complete healing of the entry wound
• Normal extraocular muscle function
• No signs of infection or other complications
• Preserved vision in the affected eye

Regular follow-up appointments ensure continued monitoring and early detection of any potential late complications.

When a 35-year-old man arrived at Burjeel Hospital’s emergency department complaining of severe back and left shoulder pain, medical staff initially suspected a common musculoskeletal issue. However, what they discovered would prove to be one of the most challenging and rare vascular emergencies ever treated at the facility.

The Mystery Behind Persistent Pain

The patient had been experiencing excruciating pain for five days, visiting two other hospitals without receiving a definitive diagnosis. His symptoms were persistent and debilitating, affecting his daily activities and causing significant distress.

Upon arrival at Burjeel Hospital, the medical team immediately recognized the severity of his condition and ordered comprehensive diagnostic tests, including a full blood workup and CT angiogram.

A Shocking Discovery: Multiple Vascular Abnormalities

The CT angiogram revealed a medical emergency that would challenge even the most experienced vascular specialists. The imaging showed serious bleeding from a ruptured left hepatic artery aneurysm, but this was just the beginning of a complex vascular puzzle.

Further examination revealed an extremely rare condition called Segmental Arterial Mediolysis, which had caused multiple life-threatening vascular abnormalities throughout the patient’s body:

• Ruptured left hepatic artery aneurysm causing active bleeding
• Dissection in the right internal carotid artery
• Aneurysm in the right common carotid artery
• Bilateral renal artery dissections with massive kidney damage
• Calcified false aneurysm in the right common iliac artery
• True aneurysm in the left iliac artery

Advanced Endovascular Treatment: A Life-Saving Intervention

Dr. Mohamed Almarzooqi, Medical Director and Consultant Interventional Radiologist, led the treatment approach. The primary concern was the actively bleeding hepatic artery aneurysm, which required immediate intervention to prevent life-threatening hemorrhage.

Using minimally invasive endovascular techniques, the surgical team successfully treated the leaking aneurysm by placing coils through the right common femoral artery. This advanced procedure stopped the bleeding and stabilized the patient’s condition.

Unexpected Complications and Heroic Medical Response

While the initial treatment was successful, the patient’s journey was far from over. He subsequently developed a right common femoral artery false aneurysm at the access site, which later ruptured into the right thigh.

This complication required an open surgical approach and became extremely complex when the patient developed Disseminated Intravascular Coagulation (DIC) and experienced massive bleeding. The medical team’s heroic response included:

• Administration of 124 units of blood and blood products
• Management of extensive open wounds in the lower abdomen and upper thigh
• Innovative wound healing using negative pressure dressing therapy

The Challenge of Conflicting Medical Needs

This case presented a unique medical dilemma that highlighted the complexity of treating Segmental Arterial Mediolysis. The patient had two conflicting medical needs:

1. Arterial dissections typically require anticoagulation therapy
2. Multiple aneurysms and active bleeding contraindicate blood thinners

Dr. Moatasiem Bukhari, Consultant Vascular Surgeon, worked closely with the interventional radiology team to navigate this challenging balance between preventing clot formation and controlling bleeding.

Remarkable Recovery and Long-term Outlook

After approximately two months of intensive care and treatment, the patient was successfully discharged from the hospital. His recovery has been remarkable, demonstrating the effectiveness of Burjeel’s multidisciplinary approach to complex vascular conditions.

The patient continues under regular follow-up care, with monitoring for any changes in his remaining vascular abnormalities. His case serves as a testament to the importance of:

• Early recognition of complex vascular emergencies
• Advanced diagnostic imaging capabilities
• Multidisciplinary expertise in interventional radiology and vascular surgery
• State-of-the-art endovascular treatment options

Why Choose Burjeel for Complex Vascular Emergencies?

This case demonstrates Burjeel’s commitment to treating even the most challenging medical conditions. Our facilities are equipped with:

• Advanced imaging technology including CT angiography
• Hybrid operating rooms for combined procedures
• Experienced vascular specialists trained in the latest techniques
• Comprehensive blood banking and transfusion services
• Intensive care units for complex post-operative management

Our Experts

A hiatal hernia can be a hidden cause of digestive discomfort, heartburn, and acid reflux. At Burjeel Medical City, we specialize in hiatal hernia treatments with advanced diagnostic and surgical care, including robotic hiatal hernia repair and laparoscopic surgery, offering patients effective, minimally invasive solutions. 

What Is a Hiatal Hernia? 

A hiatal hernia occurs when the upper part of the stomach pushes through the hiatus—the opening in the diaphragm—into the chest cavity. This can affect the normal function of the lower esophageal sphincter (LES), often leading to gastroesophageal reflux disease (GERD), which causes acid to flow back into the esophagus. 

Common hiatal hernia symptoms include: 

At Burjeel Medical City, we use advanced minimally invasive procedures to treat hiatal hernias, including laparoscopic and robotic surgery. Surgical techniques are chosen based on the hernia’s size, type, and patient-specific factors. Options include: 

Understanding the condition and its potential effects is crucial to preventing complications and improving quality of life. 

Types of Hiatal Hernia 

There are three primary types of hiatal hernias: 

1. Sliding Hiatal Hernia 
   The most common type. The stomach and lower esophagus slide up through the diaphragm. Symptoms often mimic GERD. 

2. Paraesophageal Hiatal Hernia 
   Less common but potentially more dangerous. The stomach pushes up next to the esophagus, and in rare cases, can become strangulated—a surgical emergency. 

3. Mixed (Sliding + Paraesophageal) 
   A combination of both, typically seen in larger or more complex cases. 

When Is Surgery Needed? 

While many cases are managed with medication and lifestyle changes, surgery for hiatal hernia may be required when: 

Our expert team at Burjeel Medical City carefully evaluates each case to determine the most appropriate course of treatment. 

Surgical Options for Hiatal Hernia Treatment 

At Burjeel Medical City, we use advanced minimally invasive procedures to treat hiatal hernias, including laparoscopic and robotic surgery. Surgical techniques are chosen based on the hernia’s size, type, and patient-specific factors. Options include: 

1. Hernia Repair with Nissen Fundoplication 

This is the most common surgical treatment for hiatal hernias associated with GERD. The surgeon wraps the upper part of the stomach (the fundus) around the lower esophagus to reinforce the LES and prevent acid reflux. It is typically performed via laparoscopic surgery. 

2. Partial Fundoplication (Toupet or Dor Fundoplication) 

In patients where a full 360-degree wrap (Nissen) is not suitable, a partial wrap may be performed: 

• Toupet Fundoplication involves a 270-degree posterior wrap. 

• Dor Fundoplication is an anterior 180–200-degree wrap. 
  These options are also performed minimally invasively and tailored to patients’ esophageal motility. 

3. Hernia Repair with Mesh Reinforcement 

In cases of large or recurrent hiatal hernias, laparoscopic hiatal hernia repair with mesh is recommended. A biocompatible mesh is used to strengthen the diaphragm and prevent recurrence while minimizing complications. 

All these techniques can be performed using robotic hiatal hernia repair, offering increased precision, less postoperative pain, and faster recovery. 

Recovery Time After Surgery 

Recovery from minimally invasive hiatal hernia repair is typically smooth and faster compared to open surgery: 

• Most patients return home within 24–48 hours 

• Light activities can resume within a week 

• Full recovery generally takes 2–4 weeks 

• Dietary adjustments are advised for a few weeks post-surgery 

Our team at Burjeel Medical City provides thorough postoperative care to ensure a safe and successful recovery. 

What to Avoid with Hiatal Hernia 

Post-surgery and for those managing hiatal hernias non-surgically, lifestyle and dietary changes play a key role in symptom control. Here’s what to avoid with hiatal hernia: 

• Large, heavy meals 

• Spicy, acidic, and fatty foods 

• Carbonated drinks and caffeine 

• Alcohol and tobacco 

• Lying down soon after eating 

• Wearing tight clothing around the abdomen 

Regular follow-ups, weight management, and sleep position adjustments (like elevating the head of the bed) can further support symptom relief. 

Why Choose Burjeel Medical City? 

Burjeel Medical City is a leader in advanced gastrointestinal surgery in the UAE. Our multidisciplinary team offers: 

• Expertise in laparoscopic and robotic hiatal hernia repair 

• Access to the latest technologies and minimally invasive techniques 

• Personalized care plans tailored to each patient 

• World-class facilities and compassionate support 

Take the First Step Toward Relief 

If you’re experiencing persistent hiatal hernia symptoms or chronic acid reflux, don’t ignore them. Schedule a consultation with gastro at Burjeel Medical City to explore your options for safe, effective, and minimally invasive treatment. 

Our Experts

Gastrointestinal disorders such as GERD and Achalasia can significantly impact quality of life if left untreated. While both conditions affect the esophagus and have overlapping symptoms, they are distinct in cause, diagnosis, and treatment approaches. In this blog, we’ll explore what is GERD, what is Achalasia, their symptoms, types, and the most effective treatments available today. 

What is GERD? 

GERD, or Gastroesophageal Reflux Disease, is a chronic condition where stomach acid frequently flows back into the esophagus, causing irritation and discomfort. This backwash, or acid reflux, can lead to inflammation, erosion, and long-term complications if not managed. 

GERD Meaning and Causes 

The term GERD refers to a digestive disorder where the lower esophageal sphincter (LES) doesn’t function properly, allowing acid to escape from the stomach back into the esophagus. Common causes include: 

• Weak or relaxed LES 

• Obesity 

• Hiatal hernia 

• Pregnancy 

• Smoking 

• Certain medications 

Types of GERD 

GERD is not one-size-fits-all. It can present in different forms, including: 

GERD Symptoms 

Recognizing GERD symptoms early is key to effective management. Common signs include: 

GERD Treatment: How to Cure GERD Permanently 

Wondering how to cure GERD permanently? While lifestyle changes and medications help manage symptoms, long-term relief often requires a combination of the following: 

Lifestyle Modifications: 

• Eat smaller meals 

• Avoid spicy and acidic foods 

• Maintain a healthy weight 

• Elevate the head during sleep 

• Quit smoking 

Medications: 

• Antacids 

• H2 blockers 

• Proton pump inhibitors (PPIs) 

Surgical Options: 

• Fundoplication – strengthens the LES 

• LINX device – a magnetic ring implanted to support LES function 

What is Achalasia? 

Achalasia is a rare, chronic disorder where the esophagus loses its ability to move food toward the stomach due to damage in the esophageal nerves. Unlike GERD, where acid flows up, achalasia involves a failure of the lower esophageal sphincter to relax, preventing food from entering the stomach. 

Achalasia is sometimes referred to as cardiospasm due to the spasmodic closure of the lower esophageal sphincter. 

Achalasia Causes and Risk Factors 

The exact cause of achalasia is unknown, but it may be linked to autoimmune damage or viral infections that affect the esophageal nerves. 

Achalasia Symptoms 

Symptoms of achalasia often develop gradually and may include: 

Achalasia Treatment Options

Treatment focuses on relieving symptoms by relaxing or opening the LES. 

Nonsurgical Treatment for Achalasia 

• Balloon dilation – Widens the LES using a balloon inserted endoscopically 

• Botox injections – Temporarily relaxes the LES 

• Medications – Nitrates or calcium channel blockers to relax the esophageal muscles 

Surgical Treatment for Achalasia 

• Heller Myotomy – A minimally invasive surgery to cut the LES muscle 

• POEM (Peroral Endoscopic Myotomy) – A newer endoscopic procedure with faster recovery 

• In some cases, a partial fundoplication may be combined with surgery to prevent reflux 

Best Achalasia Doctors and Where to Seek Help 

If you’re experiencing symptoms of GERD or achalasia, it’s essential to consult a specialist. The best achalasia doctors are usually gastroenterologists or thoracic surgeons experienced in advanced diagnostic and therapeutic techniques like manometry, endoscopy, and minimally invasive surgery. 

At Burjeel Medical City, our expert team offers state-of-the-art diagnostic tools and personalized treatment plans for both GERD and Achalasia, ensuring comprehensive care and long-term relief. 

In a nutshell

While GERD and Achalasia share some overlapping symptoms, they are distinct conditions that require different approaches to diagnosis and treatment. Early intervention, accurate diagnosis, and access to experienced specialists are key to managing these disorders effectively. 

If you are experiencing symptoms or looking for guidance, don’t delay—consult the experts at Burjeel Medical City today for world-class care. 

Our Experts