ABSTRACT
Splenosis results from autotransplantation of splenic tissue after traumatic splenic rupture or surgery. Usually asymptomatic, splenosis is an incidental finding at surgery, unrelated to the splenosis, for intestinal obstruction or suspected appendicitis or gynaecological pathology. This article describes a unique case of massive gastrointestinal bleeding caused by deep invasion of a splenotic nodule into the gastric wall.
Subject(s)
Gastric Fundus , Gastrointestinal Hemorrhage/etiology , Splenosis/complications , Emergencies , Gastric Fundus/diagnostic imaging , Humans , Laparotomy , Male , Middle Aged , Radiography, Abdominal , Splenectomy/adverse effects , Splenosis/diagnostic imaging , Splenosis/etiology , Splenosis/pathology , Splenosis/surgery , Time Factors , Tomography, X-Ray ComputedABSTRACT
Despite the indisputable progress of technology (laboratory analyses, scintigraphy, ultrasonography, computed tomography), the diagnosis of acute appendicitis often remains uncertain, with a rate of useless appendectomies amounting to almost 20% of cases. The ideal diagnostic test has yet to be discovered and, in any case, clinical observation remains the cornerstone of any decision-making algorithm. Thus, acute appendicitis continues to offer food for thought in relation to the aetiology of the condition, which is still unknown, the primacy of the clinical diagnosis, and the learning of the surgical skills required. In the present study, the authors compare their personal experience with the relevant data in the international literature, emphasising a number of issues such as the problem of diagnosis, acute appendicitis in pregnancy, laparoscopic therapy, and the so-called "useless appendectomies" and presenting their own point of view.
Subject(s)
Appendectomy/methods , Appendicitis/diagnosis , Appendicitis/surgery , Laparoscopy , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/surgery , Retrospective Studies , Treatment Outcome , Unnecessary ProceduresABSTRACT
Hemorrhage following prolonged oral anticoagulant administrations is a well recognized hazard of therapy, and hemorrhagic complications are said to occur in 10-30% of patients. Following the presentation of the cases, the authors examine the current literature concerning the problems with anticoagulants, and recommend models of diagnosis and treatment of complications by bowel obstruction. Authors report on two cases of small bowel obstruction due to intramural hematoma during anticoagulant therapy. It is extremely important to recognize this syndrome in order to avoid unnecessary operative intervention. Therefore, laparotomy is not indicated.
