1/4. Transvaginal extraction of the laparoscopically removed spleen.Laparoscopic removal of normal and moderately enlarged spleens has become the gold standard operation in recent years because its short operative time, technical safety, and quick patient recovery time. The best method for extraction of the removed spleen, however, has not yet been determined. The authors present a new method for the extraction of the laparoscopically removed spleen. Using a transvaginal approach, the organ is removed through an incision on the posterior vaginal wall and exteriorized in a laparobag. The procedure is similar to a routine vaginal hysterectomy, but is technically much simpler to perform.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
2/4. A true splenic cyst producing carbohydrate antigen 19-9 and cancer antigens 50 and 125, but not interleukin 10.A giant cystic lesion of the left upper abdomen associated with a smaller ovarian cyst in a young female patient is reported. Laboratory data revealed elevated serum levels of carbohydrate antigen 19-9 (CA 19-9), carcino-embryonic antigen (CEA), cancer antigens 50 and 125, and tissue polypeptide antigen. In contrast, the serum levels of interleukin 10, a cytokine involved in modulating immune responses and produced by many cancer histotypes, were normal. Since ovarian cancer or cystic adenocarcinoma of the tail of the pancreas were not ruled out, the patient underwent laparotomy. After splenectomy and ovariectomy, the tumour marker serum levels normalized. histology and immunohistochemical analysis revealed a true splenic cyst with the inner epithelium strongly positive for CA 19-9 and CEA and high levels of cancer antigens in the fluid. The ovarian lesion was a serous cystadenoma. The inner epithelium showed no immunoreactivity for tumour markers which were not measurable in the fluid. True cysts of the spleen are rare; in a few cases, high serum levels of CA 19-9 and CEA have been reported. In such instances, cyst resection or splenectomy is indicated to rule out malignant lesions and to remove the cancer antigen producing epithelium. The reported case shows that the epithelium lining true splenic cysts may produce, besides CA 19-9 and CEA, other tumour markers, in particular cancer antigens 50 and 125. In addition, normal serum values of interleukin 10 correctly predicted the benign nature of the lesion.- - - - - - - - - - ranking = 0.14285714285714keywords = spleen (Clic here for more details about this article) |
3/4. A spleen pregnancy.Non-tubal ectopic pregnancy is very rare. We report a case of spleen pregnancy, difficult to recognize clinically. The tests and investigations which led to the diagnosis and treatment are described briefly.- - - - - - - - - - ranking = 0.71428571428571keywords = spleen (Clic here for more details about this article) |
4/4. Splenic torsion presenting as a twisted hemorrhagic ovarian cyst.Torsion of a wandering spleen is rare, usually presenting as an acute abdomen and commonly misdiagnosed. In our case, a 14-year-old girl was diagnosed preoperatively as having a twisted hemorrhagic ovarian cyst. On laparotomy, an infarcted spleen that was twisted on its pedicle was found in the lower abdomen. The patient recovered uneventfully. The clinical spectrum of wandering spleen is discussed briefly.- - - - - - - - - - ranking = 0.42857142857143keywords = spleen (Clic here for more details about this article) |