ABSTRACT
BACKGROUND: Non-traumatic rupture of the spleen is a rare condition. It can occur in a pathological spleen caused by any of a variety of diseases. For yet unknown reasons this condition may sometimes involve an apparently normal spleen as well. OBJECTIVES: To examine the incidence, symptoms, causes, therapy and prognosis of "spontaneous" splenic rupture. METHODS: We conducted a retrospective study of seven patients diagnosed with splenic rupture not related to any traumatic event, who had been treated in the surgical department of a community hospital within the last 19 years. RESULTS: The male to female ratio was 5:2. In some patients, no background disease that could explain increased friability of splenic tissue could be identified. In some cases, where hemodynamic stability and absence of peritoneal signs afforded observation, splenectomy was delayed. In one case it was avoided altogether. CONCLUSIONS: "Spontaneous" rupture of spleen should be suspected when abdominal symptomatology occurs against a background of an acute infectious disease, especially in young males, or a disease known to affect target organs of the reticular endothelial system. Preoperative use of imaging studies in hemodynamically stable patients can sometimes obviate surgery, or in cases of massive hemoperitoneum reduce intraoperative time.
Subject(s)
Hemoperitoneum , Splenectomy , Splenic Rupture/diagnosis , Adolescent , Adult , Female , Humans , Male , Medical Records , Middle Aged , Retrospective Studies , Rupture, Spontaneous , Splenic Rupture/etiology , Splenic Rupture/physiopathologySubject(s)
Appendicitis/microbiology , Appendicitis/surgery , Pneumococcal Infections/diagnosis , Streptococcus pneumoniae/isolation & purification , Amoxicillin/administration & dosage , Appendectomy/methods , Appendicitis/diagnosis , Child , Female , Follow-Up Studies , Humans , Microbial Sensitivity Tests , Pneumococcal Infections/drug therapy , Risk Assessment , Severity of Illness Index , Streptococcus pneumoniae/drug effects , Treatment OutcomeABSTRACT
BACKGROUND: Subcutaneous angiocentric T cell is a common form of cutaneous lymphoma localized within subcutis mimicking lobular panniculitis. It is rarely manifested as perianal skin lesion. OBJECTIVE: To suggest that perianal T-cell lymphoma is a rare entity that should be included in the differential diagnosis of perianal infiltrate mimicking perianal abscess. METHODS AND RESULTS: A 65-year-old woman presented with painful perianal infiltrate mimicking a perianal abscess. The pain lasted seven days and there was no evidence of fever. Bacterial examination of tissue of the infiltrate discovered Staphylococcus aureus. Angiocentric T-cell lymphoma was demonstrated on biopsy. CONCLUSION: Our case represented sequela of subcutaneous angiocentric T-cell malignant lymphoma with a complication of a secondary infection mimicking perianal abscess. In patients presenting with a perianal infiltrate without abscess, a malignant condition should be considered a differential diagnosis and a biopsy should be performed.
