Splenectomy in the treatment of idiopathic thrombopenic purpura in adults. Apropos of 43 cases

Case reports of 43 patients with idiopathic thrombocytopenic purpura (ITP) operated upon from 1975 up to the present were analyzed. After revision of therapeutic indications the predictive prognostic factors for splenectomy, essentially the initial response to corticotherapy, were studied. Findings indicated that splenectomy is effective treatment for ITP since permanent total remissions were obtained in 76% with a morbidity of 16% and a mortality of 2%. Emphasis is placed on the need for minute pre-, intra- and post-operative precautions.     

Intrauterine device appendicitis: an exceptional complication

We report a case of migration of an intrauterine contraceptive device to the appendix. In this patient with a clinical presentation suggestive of appendicitis, transvaginal ultrasonography visualized a device located outside the uterus, near the small bowel. The device, which was partially embedded in the appendix, was removed via laparoscopy and laparotomy. Appendicular migration of an intrauterine device is exceptional. A literature review spanning the past years only revealed a few reported cases. Most of the authors recommend removal because of the potential for inflammatory reactions that can cause bowel obstruction and perforation.