共查询到20条相似文献,搜索用时 15 毫秒
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Lo Monte AI Labruzzo C Sardo FK Napoli N Falcone G Cuccia V Airo Farulla M Buscemi G 《Annali italiani di chirurgia》1999,70(5):759-761
We report a case of a spleen infarction caused by the vascular pedicle torsion. A 25 year-old-man, heterozygous for HbS, presented with severe abdominal pain especially in the left upper quadrant in front and in the back, fever other symptoms related to acute abdomen. First we excluded most common disease (occlusive one and hematologic one) through conform investigation, then we suspected a spleen problem. So we did further investigation with ultrasonography which showed splenomegaly and the spleen looked twisted with its hilum in contact with previous abdominal wall, moreover (here were are as of decreased signal intensity characteristic of splenic infarction under the capsule and some blood in the Douglas pouch. The patient underwent splenectomy urgently. During the intervention we saw a splenomegaly like the ultrasonography showed, moreover there were a long twisted vascular pedicle and many areas of infarctions, some of which had ruptured causing emoperitoneum. The surgical intervention was successful and the clinical spectrum was solved. The splenic infarction might be clinically silent or to represent a surgical emergency. In front a case of acute abdomen, after exclusion of most common etiology, we underline the importance to suspect a spleen suffering, especially vascular one, when (here was no history of trauma. Considering this fact, a simple not invasive examination like ultrasonography is able to confirm this kind of hypothesis and to give soon information to make the surgical choose. 相似文献
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《Cardiovascular surgery (London, England)》1995,3(6):607-610
The authors report a case of symptomatic splenic infarction secondary to cholesterol embolization after coronary artery bypass grafting in a 59-year-old woman. The patient was treated with urgent splenectomy, which was curative. The diagnosis, investigations and management of the condition are discussed. 相似文献
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Neal W Wilkinson Kurt Edwards Eric D Adams 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2003,7(4):359-365
Techniques for mobilizing the greater curve of the stomach during laparoscopic Nissen fundoplication (LNF) include division of the short gastric vessels (SGV). The splenic artery and vein lie directly posterior to the proper plane of dissection. Uncontrolled bleeding during SGV division places the splenic vessels at risk for inadvertent injury or ligation. We report herein on 2 patients referred to our institution who had left upper quadrant pain and radiographic evidence of segmental splenic infarction (SI) that resulted from a peripheral splenic artery branch injury during LNF. Management strategies included a trial of conservative management and splenectomy for persistent symptoms or complications resulting from SI. Intense inflammation and adhesion formation making laparoscopic splenectomy difficult should be anticipated when operating on the infarcted spleen. 相似文献
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BACKGROUND: Aneurysms of visceral arteries are rare, but may lead to dramatic situations of intraabdominal or retroperitoneal hemorrhage in case of rupture. CASE REPORT: We report the case of a 72-year-old patient who developed a hemorrhagic shock following a total hip replacement due to the rupture of an aneurysm of the gastroduodenal artery. Angiography also demonstrated a high-grade stenosis of the celiac trunk. The ruptured aneurysm was ligated as a live-saving procedure, but due to the stenosis in the celiac trunk the patient developed a splenic infarction followed by partial tissue liquefication. This was treated conservatively and after 3 months, the computed tomography showed an atrophic residual spleen. SUMMARY: Diagnostic and therapeutic approaches to visceral vascular aneurysms are discussed including the potential complications of splenic infarction. 相似文献
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Dulman RY Buchanan GR Ginsburg H Fefferman NR Greco MA Borys D Blei F 《Journal of pediatric surgery》2007,42(12):2129-2131
Concomitant hereditary spherocytosis and sickle cell trait, although extremely rare, could potentially lead to splenic sequestration or infarction. We report here the first case of splenic infarction in a child with hereditary spherocytosis and sickle cell trait while flying on a commercial aircraft. The presence of hypoxia, hemoconcentrated erythrocytes, and sickle hemoglobin created the perfect environment for clinical sequelae. 相似文献
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Stefano F. Agolini MD Kamalesh T. Shah MD James J. Goodreau MD Thomas M. McLoughlin Jr. MD Michael C. Sinclair MD 《Journal of vascular surgery》1997,26(6)
We report on a patient with left upper quadrant pain as a result of splenic infarction; the patient was subsequently found to have a thoracoabdominal aortic thrombus extending through the celiac axis. The patient was successfully treated with an aortic thrombectomy guided by intraoperative transesophageal echocardiography. (J Vasc Surg 1997;26:1069-72.) 相似文献
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McVay CL Zhang Y Ko A Memsic L Hamburg SI Morgenstern L Silberman AW 《The American surgeon》2004,70(1):71-74
There are few cases of splenic infarction associated with antiphospholipid antibody reported in the literature. We present two cases of splenic infarction associated with anticardiolipin antibody, one complicated by the development of a splenic pseudocyst. Clinical diagnostic features of splenic infarction are described. In addition, a review of the literature on thrombotic manifestations of antiphospholipid syndrome is presented. 相似文献
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An extremely rare yet potentially fatal complication of colonoscopy is reported. A 52-year-old female developed a splenic
subcapsular hematoma following routine colonoscopy. Conservative treatment was successful. In the English literature, only
14 similar cases have been reported. Treatment of a splenic flexure lesion, previous surgery with splenocolic adhesions, and
inflammatory bowel disease increase the risk of such a complication.
Increased awareness by surgeons and gastroenterologists should lead to prompt treatment and favorable outcome.
Received: 27 December 1996/Accepted: 12 February 1997 相似文献
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Splenic preservation 总被引:1,自引:0,他引:1
J S Chappell 《Suid-Afrikaanse tydskrif vir geneeskunde》1984,65(1):12-14
The current principle of splenic preservation in both adults and children is now well accepted, and the reason for this is outlined. The surgical anatomy is briefly discussed and a method of handling the patient with splenic trauma is described. Splenic preservation is vital as regards protection of the child against infection, both in cases involving trauma and for other conditions previously treated by splenectomy. 相似文献
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Osnat Zmora Yitzhak Kori David Samuels Ada Kessler Carl I. Schulman Joseph M. Klausner Dror Soffer MD 《European journal of trauma and emergency surgery》2009,35(2):108-114
Abstract
Background:
Proximal embolization of the splenic artery (PSAE) has recently been reported for traumatic splenic injury. The suggested
mechanism of action entails a decrease in the splenic blood pressure without ischemia due to collateral blood supply. The
main complications of selective embolization are continuous bleeding, splenic infarcts and splenic abscesses. The main complications
of observation alone are continuous bleeding and formation of splenic pseudoaneurysms. Our aim was to assess the efficacy
of PSAE in the cessation of bleeding without formation of pseudoaneurysms, and the outcome of the spleen after such intervention.
Methods:
A prospective observational study of all patients undergoing PSAE for traumatic splenic injury in our institution over a 33-month
period. Clinical and Doppler sonographic examinations were performed to assess cessation of bleeding, splenic blood flow,
and formation of splenic pseudoaneurysms, infarcts or abscesses.
Results:
During 33 months, 11 patients with blunt abdominal trauma and tomographic evidence of either high grade or actively bleeding
splenic injuries were treated by PSAE. During follow-up, no patient underwent surgery or repeated embolization. Preserved
blood flow was found on Doppler sonography in 82% of the patients and no pseudoaneurysms were demonstrated. A perisplenic
collection was found in one patient and responded well to percutaneous drainage.
Conclusions:
Proximal embolization of the splenic artery for severe splenic injury is highly successful in cessation of bleeding while
preserving splenic architecture. There were minimal complications in this series demonstrated by clinical and Doppler examinations. 相似文献
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