ABSTRACT
Accessory spleen and splenosis are two types of ectopic spleen. An accessory spleen can be found in various sites in the abdomen, but an intrahepatic accessory spleen is very rare though many case reports of intrahepatic splenosis are available. This case report presents the incidental diagnosis of accessory spleen in the liver of a 57-year-old male while undergoing laparoscopic diaphragmatic repair. The patient had a history of splenectomy 27 years ago for hereditary spherocytosis, but his routine haemogram did not show any features of the ectopic splenic function. Intraoperatively, a mass was suspected in the liver and was resected. Histopathology revealed an accessory spleen with well-preserved red and white pulp architecture. Though a history of splenectomy suggested a diagnosis of splenosis, a well-encapsulated and preserved splenic architecture confirmed the diagnosis of accessory spleen. Accessory spleen or splenosis can be diagnosed radiologically using Tc-99m-labeled heat-denatured red blood cells (HRBC) and Tc-99m sulfur colloid scans, but the gold standard is histopathological examination. Ectopic spleen is mostly asymptomatic but usually results in unnecessary surgeries as it is difficult to differentiate from benign or malignant tumors. Thus, a high degree of suspicion and awareness is necessary for early and prompt diagnosis.
ABSTRACT
The objectives of this study are to determine the prevalence of domestic accidents, describe the factors associated with domestic accidents and assess the medical and economical consequences of domestic accidents. Community-based cross-sectional study was conducted in a semi-urban area of Tamil Nadu during February 2013. A total of 3947 study participants were interviewed using a structured questionnaire. Study variables included were socio-demography, housing conditions, epidemiological factors, medical and economical consequences of domestic accidents. Means and proportions were calculated. The prevalence of domestic accidents was 12.7%. Out of 500 domestic accidents, falls (54.4%) was the most common type of domestic accident. Females and the respondents in age group of 21-40 years were more commonly affected. About 60% of victims received treatment. Mean duration of hospital stay, mean amount of money spent for treatment and mean number of days away from routine work for falls category were 16 days, US$25 and 8 days, respectively, which are higher than other types of accidents. The burden and impact of domestic accidents was high. Therefore, in order to prevent and control domestic accidents, promotion of house safety measures and creation of awareness among the community using IEC programmes have to be undertaken.
