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1.
Clin. biomed. res ; 41(2): 185-187, 2021. ilus
Article in English | LILACS | ID: biblio-1341962

ABSTRACT

Wandering spleen (WS) is a rare entity characterized by laxity of peritoneal ligaments that hold the spleen stationary. It is most commonly diagnosed in children and young women. Clinical presentation ranges from asymptomatic to acute abdomen. A 19-year-old woman came to the emergency department with history of progressive abdominal pain. She also had previous episodes of hematemesis. A computed tomography scan showed an ectopic spleen with a "whirlpool sign." Laparotomy and splenectomy were performed. WS is characterized by a long vascular pedicle and laxity of peritoneal attachments of the spleen. The etiology is usually congenital. Splenopexy is the main treatment; however, splenectomy is indicated when splenic infarction is present. Despite being rare, this condition may be considered in some cases of abdominal pain. An earlier diagnosis would have allowed us to perform a splenopexy, thus reducing morbidity. (AU)


Subject(s)
Humans , Female , Adult , Wandering Spleen/diagnosis , Wandering Spleen/complications , Abdomen, Acute/etiology , Hypertension, Portal/etiology
3.
Rev. cuba. cir ; 58(2): e669, mar.-jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1093168

ABSTRACT

RESUMEN El bazo ectópico es una enfermedad infrecuente, que se caracteriza por el aumento de la movilidad del bazo debido a la ausencia o laxitud de sus ligamentos suspensorios, lo que puede dar lugar a una torsión de su pedículo, y provocar un abdomen agudo. Se presenta el caso de una mujer de 29 años que acude al servicio de urgencias por presentar dolor abdominal de 7 meses de evolución, localizado en fosa ilíaca izquierda, que ha empeorado en las últimas 48 horas. Se realizó ecografía en el servicio de urgencias (point-of-care) que mostró una imagen compatible con bazo ectópico junto a su hilio, localizado en tercio inferior del abdomen cerca de la vejiga y del útero, y líquido libre. La tomografía axial computarizada confirmó el diagnóstico de torsión del pedículo. Se realizó laparotomía de urgencia y se localizó el bazo dentro de la pelvis con torsión del pedículo; ante un bazo no viable se realizó esplenectomía. La histología demostró cambios trombóticos difusos con infartos isquémicos y hemorrágicos del bazo. A pesar de su baja prevalencia, el bazo ectópico se debe tener en cuenta a la hora de realizar el diagnóstico diferencial en aquellas mujeres en edad fértil que consultan por dolor abdominal o masa pélvica(AU)


ABSTRACT Ectopic spleen is a rare disease, characterized by increased mobility of the spleen due to the absence or laxity of its suspensory ligaments, which can lead to torsion of its pedicle and cause acute abdomen. We present the case of a 29-year-old woman who attends the emergency department with abdominal pain of seven months of evolution and located in the left iliac fossa, which has worsened in the last 48 hours. An ultrasound was performed in the emergency department (point-of-care), which showed, next to its hilum, an image consistent with ectopic spleen, located in the lower third of the abdomen near the bladder and uterus, and free fluid. Computed axial tomography confirmed the diagnosis of pedicle torsion. Emergency laparotomy was performed and the spleen was located inside the pelvis with torsion of the pedicle. Splenectomy was performed before a non-viable spleen. Histology showed diffuse thrombotic changes with ischemic and hemorrhagic infarcts of the spleen. Despite its low prevalence, the ectopic spleen should be taken into account when making the differential diagnosis in those women at childbearing age who come to the clinic for abdominal pain or pelvic mass(AU)


Subject(s)
Humans , Female , Adult , Splenectomy/methods , Abdominal Pain/etiology , Wandering Spleen/diagnostic imaging , Laparotomy/methods , Emergency Service, Hospital
4.
Rev. cir. (Impr.) ; 71(3): 257-260, jun. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1058266

ABSTRACT

INTRODUCCIÓN: El bazo errante, es una entidad clínica poco común. Su espectro clínico varía desde enfermedad asintomática hasta complicaciones asociadas y su manejo es predominantemente quirúrgico. CASO CLÍNICO: Hombre, con cuadro clínico de dolor y masa abdominal palpable, con hallazgos tomográficos sugestivos de patología con asiento en retroperitoneo, con obstrucción intestinal secundaria; por laparotomía se identifica de forma incidental bazo ectópico solo fijado a través de pedículo vascular torsionado y signos de hipertensión portal, realizándose esplenectomía. CONCLUSIONES: La torsión esplénica es la complicación más frecuente del bazo errante, una entidad bastante rara con muy pocos casos publicados en Colombia.


BACKGROUND: The wandering spleen is an uncommon clinical entity. Its clinical spectrum varies from asymptomatic disease to associated complications and its management is predominantly by surgery. CLINICAL CASE: Man with clinical picture of pain and palpable abdominal mass, with tomographic findings suggestive of pathology with retroperitoneal seating, with secondary intestinal obstruction; by laparotomy incidentally, an ectopic spleen is identified, only fixed through a torsioned vascular pedicle and signs of portal hypertension, performing splenectomy. CONCLUSIONS: Splenic torsion is the most frequent complication of the errant spleen, a very rare entity with very few cases published in Colombia.


Subject(s)
Humans , Male , Adolescent , Torsion Abnormality/surgery , Wandering Spleen/surgery , Splenectomy , Splenic Infarction/etiology , Splenomegaly , Torsion Abnormality/complications , Torsion Abnormality/diagnostic imaging , Tomography, X-Ray Computed , Abdominal Pain/etiology , Wandering Spleen/complications , Wandering Spleen/diagnostic imaging
5.
The Egyptian Journal of Hospital Medicine ; 76(7): 4533-4537, 2019. ilus
Article in English | AIM | ID: biblio-1272771

ABSTRACT

Background: The incidence of torn anterior cruciate ligament (ACL) has greatly increased, with today's increasing enthusiasm for sports activities. As a result, reconstruction of the torn anterior cruciate ligament became a common surgical procedure in orthopaedic surgery. Objective: To evaluate short term clinical outcome of adjustable suspensory fixation for femoral graft in ACL reconstruction. Methods: All patients treated for ACL reconstruction with an ipsilateral hamstring between March 2017 and March 2018 were evaluated. Subjects were assigned to TightRope™ (TR) femoral fixation. All patients were evaluated with the Lachman test, pivot-shift test, 2000 International Knee Documentation Committee (IKDC) knee examination. The subjective evaluation was performed using the Lysholm knee score. CT examination was performed to evaluate femoral and tibial tunnels enlargement at four different levels. All patients were assessed at a 12 month follow-up visit. Power analysis was performed a priori in accordance with the femoral and tibial tunnels enlargement values from the CT scans. Results: The group was homogenous at baseline with regard to age, gender, BMI, dominance and disease duration. At the final follow-up, no statistically significant differences were found according to subjective and objective clinical outcome measures. According to the femoral tunnel enlargement, no statistically significant difference was found between tunnel at operation and 12 months later. Conclusion: In transtibial ACL reconstruction, the use of adjustable-loop length device products, on the femoral side, led to better clinical and radiological results


Subject(s)
Cubital Tunnel Syndrome , Metal-Organic Frameworks , Surgical Fixation Devices , Wandering Spleen
6.
Article in English | WPRIM | ID: wpr-760878

ABSTRACT

Gastric volvulus (GV) is an uncommon pathology, with 10-20% of cases occurring in children, typically before one year of age. It often occurs in people with congenital diaphragmatic hernias, intestinal malrotation, eventration of the diaphragm, paraesophageal hernias, wandering spleens, asplenism, or intra-abdominal adhesions. We report a rare case of chronic GV after left hemihepatectomy for hepatoblastoma in a child. The patient was a 9-year-old boy who complained of upper abdominal pain and postprandial upper abdominal distension for one year. At the age of 4 months, he was diagnosed with hepatoblastoma and had undergone left hemihepatectomy. The upper gastrointestinal contrast study revealed chronic organoaxial gastric volvulus. After a surgical procedure involving adhesiolysis and an anterior wall gastropexy, the patient improved and the symptoms resolved. Although GV is a rare disease, it should be suspected in a patient with a previous abdominal surgical history who is complaining of abdominal distension and pain.


Subject(s)
Abdominal Pain , Child , Diaphragm , Gastropexy , Hepatectomy , Hepatoblastoma , Hernia, Hiatal , Hernias, Diaphragmatic, Congenital , Humans , Male , Pathology , Rare Diseases , Stomach Volvulus , Wandering Spleen
8.
Medicina (B.Aires) ; 77(1): 43-45, feb. 2017. ilus
Article in Spanish | LILACS | ID: biblio-841632

ABSTRACT

El síndrome de bazo errante es una condición infrecuente en la cual existe ausencia o hiperlaxitud en los elementos de fijación esplénicos que predispone a una ubicación inusual en el abdomen y mayor riesgo de torsión e infarto visceral. Su etiología puede ser congénita o adquirida y la presentación clínica es variable. El diagnóstico se basa en sospecha clínica, laboratorio y estudios por imágenes. La cirugía es el único tratamiento definitivo para esta afección. Presentamos el caso de una mujer de 23 años de edad con antecedentes de episodios recurrentes de dolor en hipocondrio izquierdo desde la infancia. Al examen físico se encontraba hemodinámicamente estable, afebril y con dolor en hipocondrio izquierdo. La ecografía mostró esplenomegalia homogénea y la tomografía de abdomen evidenció un bazo aumentado de tamaño, de posición conservada, con arremolinamiento y congestión de los vasos en el hilio esplénico. Se interpretó el cuadro como isquemia esplénica secundaria a torsión del pedículo vascular. Se realizó laparoscopia exploradora que evidenció bazo de 18 cm libre en hipocondrio izquierdo, con venas varicosas en la periferia y sin ligamentos de fijación. Se realizó esplenectomía por vía laparoscópica. La anatomía patológica informó necrosis isquémica del órgano. Evolucionó favorablemente con alta hospitalaria al tercer día postoperatorio.


Wandering spleen syndrome is a rare condition in which absence or laxity of splenic fixing elements predisposes to an unusual location in the abdomen and an increasing risk of twisting and infarction. Its etiology may be congenital or acquired and clinical presentation is variable. Diagnosis is based on clinical suspicion, laboratory and imaging. Surgery is the only definitive treatment for this pathology. We report the case of a 23 year old woman with a history of recurrent episodes of abdominal pain in the left upper quadrant since childhood. On physical examination she was afebrile, hemodynamically stable, with marked abdominal tenderness in the left upper quadrant. Ultrasonography showed homogeneous splenomegaly. Abdominal CT-scan presented an enlarged, eutopic spleen, with swirling and congestion of hilum vessels. Splenic ischemia due to organ torsion was suspected. Exploratory laparoscopy was performed showing an 18 cm in diameter spleen free in left upper quadrant, with varicose veins in the periphery and without fixing ligaments. Laparoscopic splenectomy was completed. The pathology report showed ischemic necrosis of the organ. The patient progressed favorably and was discharged on the third postoperative day.


Subject(s)
Humans , Female , Young Adult , Wandering Spleen/complications , Abdomen, Acute/etiology , Splenectomy , Wandering Spleen/surgery , Wandering Spleen/diagnosis , Abdomen, Acute/surgery
9.
Singapore medical journal ; : e198-200, 2014.
Article in English | WPRIM | ID: wpr-244763

ABSTRACT

Wandering spleen or splenoptosis is an uncommon entity and often an asymptomatic finding of acute abdomen in the emergency department. A high index of suspicion for splenic torsion is required, particularly in patients with known splenomegaly, as this condition could potentially lead to splenic infarction. Recognition of this condition can help avoid potential confusion with acute abdomen of other aetiologies. Herein, we present a unique case of wandering spleen with chronic torsion, which, to the best of our knowledge, has never been described in an elderly patient with haemoglobin H thalassaemia. We also review the literature for the aetiology and pathogenesis of wandering spleen, and discuss the relevant diagnostic modalities and treatment options.


Subject(s)
Abdominal Pain , Aged , China , Ethnology , Female , Hospitals , Humans , Singapore , Thalassemia , Tomography, X-Ray Computed , Torsion Abnormality , Diagnosis , General Surgery , Wandering Spleen , Diagnosis , General Surgery
10.
Article in English | WPRIM | ID: wpr-23914

ABSTRACT

Wandering spleen is a rare clinical condition caused by lax splenic suspensory ligaments. The laxity of ligaments causes torsion of splenic vascular pedicle. CT scan of a 7-year-old girl with abdominal pain showed a non-enhancing lobular mass in lower abdomen. Small bowel loops were located at the right-sided abdomen and colonic loops at the left-sided abdomen. MRI scan showed non-enhancing heterogeneous mass with twisted vascular pedicle. To our knowledge, only a few cases have been reported about wandering spleen diagnosed on MRI.


Subject(s)
Abdomen , Abdominal Pain , Child , Colon , Female , Humans , Infarction , Ligaments , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Wandering Spleen
11.
Medisan ; 15(8)ago. 2011. ilus
Article in Spanish | LILACS | ID: lil-616351

ABSTRACT

Se describe el caso clínico de una joven embarazada, en quien se diagnosticó un tumor abdominal que obligó a interrumpir de inmediato la gestación. Días después comenzó a experimentar los signos y síntomas característicos de un abdomen agudo peritoneal, considerado como una complicación del proceso patológico ya señalado. Los estudios de imagenología mostraron un bazo ectópico, por lo cual se impuso la ejecución de una esplenectomía total. En el acto quirúrgico se halló que esa víscera había provocado una lesión vascular irreversible, atribuible a su posición anatómica anormal, con un pedículo muy largo y torcido; pero la evolución fue satisfactoria.


The case report of a young pregnant woman, in whom an abdominal tumor was diagnosed which immediately forced to interrupt pregnancy is described. Some days later she began to experience the characteristic signs and symptoms of a peritoneal acute abdomen, considered as a complication of the above menctioned pathological process. The imaging studies showed an ectopic spleen, reason why a total splenectomy was decided. During surgery it was found that this viscera had caused an irreversible vascular injury, attributable to its abnormal anatomical position, with a very long and bent pedicle; but the clinical course was satisfactory.


Subject(s)
Humans , Female , Pregnancy , Middle Aged , Wandering Spleen , Laparoscopy , Splenectomy
12.
Appl. cancer res ; 30(1): 232-235, Jan.-Mar. 2010. ilus
Article in English | LILACS, Inca | ID: lil-547644

ABSTRACT

Wandering spleen is the consequence of excessive splenic mobility due to ineffective peritoneal attachment, rarely associated to splenic cysts. In cases previously reported, splenic cysts are mostly pseudocystic formations from trauma, infarction or parasitic disease. True cysts, epithelial or mesothelial lined, which are considered dysontogenetic formations, are usually not associated to wandering spleen. Angiomyolipoma is a benign triphasic tumor, usually renal. Few cases of wandering spleen associated with mesothelial cyst or angiomyolipoma are described. We present the first case to our knowledge of these three entities together; isolated evidence, once compiled, may lead to the influence of estrogen as a common factor in pathogenesis. Even though a punctual intervention in a benign panorama, we question whether these lesions act as distinct, partially associated or as the manifestation of an underlying silent syndromic disease that could harbor future outcomes to similar patients.


Subject(s)
Angiomyolipoma , Dermoid Cyst , Estrogens , Neoplasms, Mesothelial , Pregnancy , Wandering Spleen
14.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2009; 19 (2): 123-124
in English | IMEMR | ID: emr-91611

ABSTRACT

Wandering spleen is a rare cause of acute abdomen. Generally, it remains asymptomatic, it may present clinically as a painless mobile mass or rarely as an acute abdomen when the wandering spleen twists on its pedicle, resulting in splenic congestion, infarction with or without involvement of neighbouring visceras. Here, we present an unusual case of torsion of a wandering spleen, which resulted in congestive splenomegaly and small bowel obstruction as a rare case of acute abdomen


Subject(s)
Humans , Female , Wandering Spleen/diagnosis , Wandering Spleen/surgery , Abdomen, Acute/etiology , Abdomen, Acute/diagnosis , Torsion Abnormality , Splenomegaly/etiology , Splenic Infarction , Intestinal Obstruction , Splenectomy
16.
Article in Korean | WPRIM | ID: wpr-195594

ABSTRACT

Gastric volvulus is a rare disease; only 700 cases have been reported since Berti first described autopsy findings of a patient in 1866. Its symptoms are non-specific and therefore it is difficult to diagnose it early. Acute gastric volvulus has a poor prognosis because it may cause shock and strangulation. Perforation or gastric hemorrhage can also result from ischemia when diagnosis is delayed. Therefore, it requires rapid diagnosis and an emergency operation. Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all of the ligaments that hold the spleen in its normal position in the abdomen. Wandering spleen and gastric volvulus have a common cause lack of intraperitoneal visceral ligaments. The authors now report a case of wandering spleen accompanying gastric voluvulus, which resulted in wandering spleen and perforation.


Subject(s)
Abdomen , Autopsy , Emergencies , Hemorrhage , Humans , Ischemia , Ligaments , Prognosis , Shock , Spleen , Stomach Volvulus , Wandering Spleen
17.
Indian J Pediatr ; 2008 Nov; 75(11): 1181-2
Article in English | IMSEAR | ID: sea-78771

ABSTRACT

A young female child presented to our OPD for evaluation of recurrent abdominal pain. During the process of investigation USG abdomen and subsequently CECT abdomen revealed pelvic location of spleen. Splenopexy was performed and patient discharged. Patient is asymptomatic and on regular follow up.


Subject(s)
Abdominal Pain/etiology , Female , Humans , Laparoscopy/methods , Recurrence , Splenectomy/methods , Tomography, X-Ray Computed , Torsion Abnormality/diagnostic imaging , Treatment Outcome , Wandering Spleen/complications
18.
Oman Medical Journal. 2008; 23 (4): 287-288
in English | IMEMR | ID: emr-103949

ABSTRACT

A young male presented with acute abdominal pain of 4 days. Treated as appendicular mass, which did not responds to conservative management. Ultra Sound scan and CT abdomen failed to give a definite diagnosis of the tender fixed mass in lower abdomen. Laparotomy proved the mass to be an engorged large spleen twisted on its long vascular pedicle, the ischemic spleen adherent to bowel loops and posterior peritoneum. Splenectomy performed. Postoperative reactionary hemorrhage required re-exploration and clearance of clots. Patient had uneventful recovery


Subject(s)
Humans , Male , Torsion Abnormality/diagnosis , Abdomen, Acute , Abdominal Pain , Wandering Spleen/diagnosis
19.
Egyptian Journal of Surgery [The]. 2008; 27 (3): 148-151
in English | IMEMR | ID: emr-86247

ABSTRACT

To present a rare case of congenital polysplenia in adult patient present with sudden abdominal pain due to twisted wondering spleen in the pelvis. This is a single case report investigated preoperative and examined clinically where surgical intervention was performed due to rapidly progressive enlarged hypogastric mass. Result: Adult man with polysplenia and minor congenital heart disease presented with twisted accessory spleen wondering in the pelvis with long pedicle. Discussion: Polysplenia syndrome [PSS] is a type of situs ambiguous, usually associated with severe congenital heart diseases and rarely these patient reached adult life. The unique sign of the polysplenia is the presence of multiple spleens, ranging from 2 to 16. We present a case of polysplenia in adult patient with minor heart anomalies and four spleens one of them is very huge and discovered as emergency with torsion wondering pelvic spleen


Subject(s)
Humans , Male , Spleen/surgery , Torsion Abnormality , Wandering Spleen , Splenic Diseases
20.
Iranian Journal of Radiology. 2008; 5 (3): 141-144
in English | IMEMR | ID: emr-143397

ABSTRACT

Ectopic spleen is a rare entity. It is more common in children than in adults and it is about 15 times more common in females. Here we report a patient with an ectopic spleen who was referred for sonographic evaluation of an asymptomatic pelvic mass by a gynecologist. At sonography, a big homogenous mass located at the RLQ of the abdomen and the right pelvic cavity was detected. Further investigation by color Doppler sonography showed that the mass is an ectopic spleen and the main spleen could not be detected at its normal location. In the abdominopelvic CT scan, the spleen was located at the RLQ, no splenic tissue was found in the left hypochondrium, and this region was occupied by the left colon and stomach. Ectopic spleen, though very rare, should be considered in the differential diagnosis of asymptomatic pelvic masses


Subject(s)
Humans , Female , Wandering Spleen/diagnosis , Ultrasonography, Doppler, Color , Diagnosis, Differential , Tomography, X-Ray Computed , Pelvis
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