ABSTRACT
Aneurysm of the splenic artery which arises from the superior mesenteric artery is a very rare condition with less than twenty cases described in the literature. Most of the time, it is asymptomatic and the diagnosis is fortuitous, but the patient can feel epigastric or left upper quadrant discomfort. One can palpate an abdominal mass or hear an abdominal systolic murmur. The most fatal presentation is the life-threatening rupture. We report the case of a 41-year-old woman presenting an aneurysm of the splenic artery originating from the superior mesenteric artery treated surgically by simple aneurismal resection with neither arterial reconstruction nor splenectomy. The different treatment modalities are discussed, taking into account the presence of the vascular malformation.
Subject(s)
Aneurysm/surgery , Splenic Artery/abnormalities , Splenic Artery/surgery , Abdominal Pain/etiology , Adult , Aneurysm/diagnostic imaging , Female , Humans , Imaging, Three-Dimensional , Ligation , Splenic Artery/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Gastric volvulus is an uncommon entity. Management is principally surgical. Diagnosis is often delayed because of the non-specific nature of the symptoms. The authors report two cases of gastric volvulus seen in a six month period. The first is an acute presentation diagnosed by computed tomography with incarceration and necrosis of the stomach, the transverse colon and great omentum. The issue was immediate laparotomy for total gastrectomy, colectomy, terminal colostomy and omentectomy. The patient survived, and the colostomy was closed and continuity restored three months later. The second one is a chronic form diagnosed by gastroscopy and barium swallow radiography. The treatment was elective with closure of the hiatus, Nissen procedure and gastropexy. The pathophysiology, classification and treatment of those two kinds of volvulus are briefly reviewed.
