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By Giovanni Gambino M.D. Ph.D.
R Parker, G Gravante, M Elshaer, N Humayun, H Ebdewi
INTRODUCTION: Spontaneous splenic rupture is a rare but dangerous event that requires prompt diagnosis and frequently an emergency splenectomy. Previous case reports have described the occurrence in patients with medical conditions, anticoagulant treatments, endoscopic procedures, laparoscopic surgery or no particular predisposing factor. Our report is the first to describe the occurrence of spontaneous spleen rupture following a laparotomy conducted in the lower abdomen. CASE HISTORY: A 62-year-old woman presented with a 10-day history of right iliac fossa pain radiating to the right leg and associated vomiting...
March 2015: Annals of the Royal College of Surgeons of England
L Chastang, T Bège, M Prudhomme, A C Simonnet, A Herrero, F Guillon, D Bono, E Nini, T Buisson, G Carbonnel, L Passebois, C Vacher, M-C Le Moine
PURPOSE OF THE STUDY: The management of the severe blunt splenic injuries remains debated. The aim of this study is to evaluate the morbidity and mortality of splenic injury according to severity and management (surgery, embolization, non-operative management [NOM]). METHODS: A prospective multicenter study was conducted including patients aged 16 years and older with diagnosed splenic injury. We evaluated severity according to the AAST classification, the presence of hemoperitoneum or a contrast blush on initial CT scan...
April 2015: Journal of Visceral Surgery
Gregorio Tugnoli, Elisa Bianchi, Andrea Biscardi, Carlo Coniglio, Salvatore Isceri, Luigi Simonetti, Giovanni Gordini, Salomone Di Saverio
Non-operative management (NOM) of hemodynamically stable patients with blunt splenic injury (BSI) is the standard of care, although it is associated with a potential risk of failure. Hemodynamically unstable patients should always undergo immediate surgery and avoid unnecessary CT scans. Angioembolization might help to increase the NOM rates, as well as NOM success rates. The aim of this study was to review and critically analyze the data from BSI cases managed at the Maggiore Hospital Trauma Center during the past 5 years, with a focus on NOM, its success rates and outcomes...
October 2015: Surgery Today
Girolamo Geraci, Antonino Picciurro, Andrea Attard, Giuseppe Modica, Massimo Cajozzo, Carmelo Sciumè
BACKGROUND: Laparoscopic cholecystectomy (LC) is generally safe and well-accepted. In rare cases, it is associated with complications (intra- e postoperative bleeding, visceral injury and surgical site infection). Splenic lesion has been reported only after direct trauma. We report an unusual case of splenic rupture presenting after "uncomplicated" LC. CASE PRESENTATION: A 77-year-old woman presented with distended abdomen, tenderness in the left upper quadrant and severe anemia 12 hours after LC...
December 11, 2014: BMC Surgery
Carl Rosati, Ashar Ata, Gary P Siskin, Domenic Megna, Daniel J Bonville, Steven C Stain
BACKGROUND: Management of splenic trauma has evolved, with current practice favoring selective angiographic embolization and non-operative treatment over immediate splenectomy. Defining the optimal selection criteria for the appropriate management strategy remains an important question. METHODS: This retrospective registry review was conducted at a Level I trauma center. The patient population consisted of 20,561 patients in the State Trauma Registry from April 2004 to May 2012...
February 2015: American Journal of Surgery
Juan I Arcelus
No abstract text is available yet for this article.
October 2014: JAMA Surgery
Naina Bagrodia, Anna M Button, Philip M Spanheimer, Mary E Belding-Schmitt, Lori J Rosenstein, James J Mezhir
IMPORTANCE: Splenectomy is a commonly performed operation; however, data from large series regarding operative outcomes to help guide decision making and informed consent are lacking. OBJECTIVE: To evaluate clinical and pathologic variables associated with morbidity and mortality following elective splenectomy for benign and malignant hematologic conditions in the United States. DESIGN, SETTING, AND PARTICIPANTS: A review of the American College of Surgeons National Surgical Quality Improvement Program data for elective splenectomy between January 1, 2005, and December 31, 2011, was performed, and 1715 eligible individuals were identified...
October 2014: JAMA Surgery
Dimitrios Anyfantakis, Miltiades Kastanakis, Paraskevi Karona, Giorgios Fragiadakis, Ioannis Kokkinos, Emmanouil Bobolakis
Atraumatic rupture of a normal spleen represents a rare clinical phenomenon. We report on an atypical presentation of a spontaneous splenic rupture in a 44-year-old previously healthy Greek male admitted to the emergency department due to left-sided pleuritic thoracic pain in the course of a pneumonia diagnosed 2 days before. During his stay, pain extended to the epigastric region. Abdominal examination revealed generalized tenderness. We presume that coughing secondary to respiratory infection was the main factor that precipitated splenic rupture...
2014: Case Reports in Surgery
Ibrahim Afifi, Hassan Al-Thani, Sajid Attique, Sherwan Khoschnau, Ayman El-Menyar, Rifat Latifi
Adult intussusception (AI) following blunt abdominal trauma (BAT) is a rare surgical condition. We present a case of delayed diagnosis of ileocecal junction intussusception with a perforation of small bowel in a 34-year-old male with a history of fall from height. Initial exploratory laparotomy revealed shattered spleen requiring splenectomy. Initial abdominal computerized tomography scanning (CT) scan showed dilated small bowel with no organic obstruction. Patient started to improve with partial distention and was shifted to rehabilitation unit...
2013: Case Reports in Surgery
Peeyush Varshney, Bhupen Songra, Shivank Mathur, Sudarshan Gothwal, Puneet Malik, Mahnedra Rathi, Rajveer Arya
Introduction. Splenic artery Pseudoaneurysm, a complication of chronic pancreatitis, presenting as massive hematemesis is a rare presentation. Case Report. We present a case of 38-year-old male admitted with chief complaints of pain in the upper abdomen and massive hematemesis for the last 15 days. On examination there was severe pallor. On investigating the patient, Hb was 4.0 gm/dL, upper GI endoscopy revealed a leiomyoma in fundus of stomach, and EUS Doppler also supported the UGI findings. On further investigation of the patient, CECT of the abdomen revealed a possibility of distal pancreatic carcinoma encasing splenic vessels and infiltrating the adjacent structure...
2014: Case Reports in Surgery
Safak Ozturk, Mutlu Unver, Burcin Kibar Ozturk, Eyup Kebapci, Osman Bozbiyik, Varlık Erol, Nihat Zalluhoglu, Mustafa Olmez
Introduction. Hydatid disease (HD) is an infestation that is caused by the larval stage of Echinococcus granulosus. The liver is affected in approximately two-thirds of patients, the lungs in 25%, and other organs in a small proportion. Primary retroperitoneal hydatid cyst is extremely rare. The most common complaint is abdominal pain; however, the clinical features of HD may be generally dependent on the location of the cyst. Case Presentation. A 43-year-old female was admitted with the complaint of abdominal pain...
2014: Case Reports in Surgery
H Tranchart, P Lainas, D Tzanis, S Ferretti, G Pourcher, N Devaquet, I Dagher
No abstract text is available yet for this article.
April 2014: Journal of Visceral Surgery
I Ll Davies, J Cho, M H Lewis
INTRODUCTION: Splenectomy is performed both as an emergency procedure following trauma and electively when indicated for haematological disease. Postsplenectomy patients receive immunotherapy vaccines and continuous antibiotic prophylaxis. Despite well documented concerns regarding complications and overwhelming postsplenectomy infection (OPSI) risk, there appears to be only a small amount of consistent data on long-term outcomes. The authors therefore present their postsplenectomy patient outcomes over an 18-year follow-up period...
March 2014: Annals of the Royal College of Surgeons of England
D R Hildebrand, A Ben-Sassi, N P Ross, R Macvicar, F A Frizelle, A J M Watson
No abstract text is available yet for this article.
April 2, 2014: BMJ: British Medical Journal
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