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UMHS Student Christopher Zarour Discusses Hernias & Ulcers at Poster Project Competition

Posted by Scott Harrah
August 10, 2017

UMHS student Christopher C. Zarour recently took Second and Third Place in the 2017 Poster Competition at McLaren Oakland Hospital in Michigan. Mr. Zarour gave presentations on a novel treatment for Inferior Pancreaticoduodenal Artery Aneurysm and “Not Your Average Hernia,” about a Spigelian hernia. In addition, he gave a presentation on Pyoderma Gangrenosum caused by Rituximab, painful ulcerations often found on the lower extremities.

Mary Abel, UMHS Clinical Site Coordinator at McLaren Oakland, contacted the UMHS Endeavour about Mr. Zarour’s success.

“He was the only student to present this year,” she said. “This was quite impressive. He had Residents on his research! I am always thrilled at how amazing our students are. Chris has an impeccable work ethic and is always giving his all. He represents this University and himself with excellence and integrity. He is very well liked at Oakland by his peers and fellow students. I know Chris will make an excellent physician.”

The UMHS Endeavour caught up with this bright future doctor to talk about the research and presentations.

Christopher C. Zaruour gave a poster presentation on Inferior Pancreaticoduodenal Artery Aneurysm. Photo: Courtesy of McLaren Oakland Hospital

Christopher C. Zaruour gave a poster presentation on Inferior Pancreaticoduodenal Artery Aneurysm. Photo: Courtesy of McLaren Oakland Hospital

UMHS Endeavour: Tell us a little about the Poster Project Competition at McLaren Oakland. You talked about Inferior Pancreaticoduodenal Artery Aneurysm. What are some of the important things you discussed about this?

Christopher Zarour: The McLaren Oakland Poster Project Competition is an event that allows Resident Physicians and medical students to present their ongoing research or interesting case presentations. I had the luxury of working with many different Resident Physicians and Attending Physicians at McLaren Oakland Hospital. Essentially, it’s a platform that allows us to get out what we’ve learned to other specialties within the hospital.

One of my cases that I presented was a novel treatment for an Inferior Pancreaticoduodenal Artery Aneurysm caused by Median Arcuate Ligament Syndrome. Inferior pancreaticoduodenal artery aneurysm can be linked to celiac artery compression when there is an anatomical malposition of the median arcuate ligament. The median arcuate ligament crosses over the aorta and links both sides of the diaphragm. Depending on the origin and positioning of the celiac axis off the aorta, there is a possibility that it can be susceptible to compression by the median arcuate ligament. Thus, there is increased flow to the superior mesenteric artery (SMA) and its branching tributaries providing retrograde flow to the celiac axis. This increased flow renders the inferior pancreaticoduodenal artery (IPDA) susceptible to aneurysm formation. What was interesting with this case was that instead of embolizing the leaking aneurysm and compromising further blood flow distally, we felt that placing a covered stent was a better option. The result was successful and the patient responded well to treatment.

You also did a presentation “Not Your Average Hernia.” Can you give us some highlights?

There are various types of abdominal hernias. Spigelian hernias account for approximately 1% of all abdominal hernias. A patient present to the Emergency Department at McLaren Oakland Hospital with right flank pain consistent with a right-sided kidney stone. A CT abdomen and pelvis was obtained that revealed no kidney stone present, but rather an incidental finding of an asymptomatic left sided Spigelian hernia. A Spigelian hernia is a hernia that occurs at or below the arcuate line through a defect in aponeurosis of the internal oblique and transverse abdominal muscles (along the semilunar line). Lateral ventral hernia is another name for this type of hernia. Treatment is surgical due to risk of bowel strangulation and incarceration. Open and laparoscopic techniques are both options, with the placement of mesh to repair the defect.

Future doctor Christopher C. Zarour giving a poster presentation on Pyoderma Gangrenosum caused by Rituximab. Photo: Courtesy of McLaren Oakland Hospital

Future doctor Christopher C. Zarour giving a poster presentation on Pyoderma Gangrenosum caused by Rituximab. Photo: Courtesy of McLaren Oakland Hospital

In addition, you spoke about Pyoderma Gangrenosum caused by Rituximab. What are some things medical students should know about this?

Pyoderma Gangrenosum (PG) can be described as non-infectious neutrophilic purulent cutaneous ulcerations. These ulcers are extremely painful and develop quickly and is commonly observed on the lower extremities. The cause of PG can be from a magnitude of various diseases or drugs, but the exact cause remains unknown. However, there have been documented studies that shows associations to PG to range from Inflammatory Bowel Diseases and various autoimmune diseases to chemotherapeutic agents such as Rituximab. PG is a rare disease that affects females more than males. PG does, however, occur in about 4% of all infants and roughly a range of three and 10 per million every year. Diagnosis maybe difficult to assess initially, but it is imperative that a quick diagnosis is made and proper treatment is administered.

What should students know about the Poster Project Competition?

Generally speaking, I feel that students will learn so much information from presenting their interesting cases or research. Poster competitions in any hospital allow students to interact with physicians of all sorts. It is really exciting, because it allows others to ask questions and further strengthening the knowledge that the student learned and being able to potentially teach a topic that many may not know.

 Can you talk about some of the best things about working at McLaren Oakland?

McLaren Oakland Hospital gave me the opportunity to complete my Clinical Science Clerkships. This hospital allowed me to fully experience the curriculum of Intern year as a third and fourth- year medical student. The pathology that I’ve seen, along with the knowledge of all the Attending Physicians and Resident Physicians, prepared me for any USMLE examination. It also gave me the opportunity to learn with Michigan State University medical students and build friendships with many medical professionals. McLaren Oakland Hospital has been and will always be an invaluable resource to my future medical career.

Christopher C. Zarour (center) discussing one of his presentations at McLaren Oakland. 'Poster competitions in any hospital allow students to interact with physicians of all sorts,' he said. Photo: Courtesy of McLaren Oakland Hospital

Christopher C. Zarour (center) discussing one of his presentations at McLaren Oakland. 'Poster competitions in any hospital allow students to interact with physicians of all sorts,' he said. Photo: Courtesy of McLaren Oakland Hospital

(Top photo) UMHS student Christopher C. Zarour recently took Second and Third Place in the 2017 Poster Competition at McLaren Oakland Hospital in Michigan. Photo: Courtesy of McLaren Oakland Hospital



About UMHS:

Built in the tradition of the best US universities, the University of Medicine and Health Sciences focuses on individual student attention, maintaining small class sizes and recruiting high-quality faculty. We call this unique approach, “personalized medical education,” and it’s what has led to our unprecedented 96% student retention rate, and outstanding residency placements across the US and Canada. UMHS is challenging everything you thought you knew about Caribbean medical schools.

Posted by Scott Harrah

Scott is Director of Digital Content & Alumni Communications Liaison at UMHS and editor of the UMHS Endeavour blog. When he's not writing about UMHS students, faculty, events, public health, alumni and UMHS research, he writes and edits Broadway theater reviews for a website he publishes in New York City, StageZine.com.

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