11/103. Nodular hepatic and splenic sarcoidosis in a patient with normal chest radiograph.Almost all the patients with sarcoidosis have an abnormal chest radiograph, while nodular lesions of both the liver and the spleen is an unusual manifestation of abdominal sarcoidosis. We report a case of a patient with numerous hypodense nodular hepato-splenic lesions on abdominal CT and a normal chest X-ray. biopsy of an hepatic lesion revealed sarcoidosis.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
12/103. Epithelial (epidermoid) splenic cysts in childhood: surgical management of eight cases.We report eight cases of splenic epithelial cysts in childhood to summarize our clinical experience and to discuss surgical management. Six boys and two girls, aged 8 to 14 years (mean 10.8 years) were diagnosed over a 16-year period. No patients had a history of preceding trauma or related infection. Presenting symptoms were dull (two) or acute (one) left hypochondrium pain and diffuse abdominal pain (one). In four children the cyst was an incidental finding. Ultrasound and/or CT revealed cysts of diameter 2.9 to 14 cm and radionuclide scan showed a reduced uptake in the splenic area of concern. At operation variable amounts--up to 1500 mL--of liquid were aspirated from the cysts. splenic artery ligation was undertaken in six cases adjunctively to cystectomy. One total splenectomy was performed because the splenic parenchyma was totally replaced by the cyst. recurrence occurred in one case, in which multiple tiny communicating cysts were detected. histology revealed epithelial (n = 5) or stratified squamous (n = 3) lining. Five patients were seen again 0.5 to 5 years later and they were asymptomatic and with a normal ultrasound, CT, or radionuclide scan. Cyst excision was an effective treatment. Adjunctive splenic artery ligation when performed controlled hemorrhage. Other surgical methods to manage splenic cysts are discussed.- - - - - - - - - - ranking = 32.863811702479keywords = abdominal pain (Clic here for more details about this article) |
13/103. Complications of partial splenic embolization in cirrhotic patients.In recent years, partial splenic embolization (PSE) has been widely used in patients with cirrhosis and hypersplenism caused by portal hypertension. We investigated the complications associated with PSE cases seen in our hospital. Seventeen cases of liver cirrhosis that had undergone PSE were examined to investigate the complications associated with it. Mean infarcted area of the spleen was 66.2%. Leukocyte and platelet counts in 16 of 17 patients were seen to improve after PSE and persisted for at least one year. The most frequent side effects were abdominal pain (82.4%) and fever (94.1%). Severe side effects were seen in two of those 17 patients. One patient died from acute on chronic liver failure. The other patients contracted bacterial peritonitis and splenic abscess and needed drainage of splenic abscess before recovery. These two cases were in child-Pugh class B. In conclusions, PSE is a useful treatment for patients with cirrhosis and hypersplenism caused by portal hypertension. However, the possibility of severe complications, especially in patients with noncompensated cirrhosis, should be kept in mind.- - - - - - - - - - ranking = 32.863811702479keywords = abdominal pain (Clic here for more details about this article) |
14/103. Splenic abscess in childhood B-thalassemia Major.Splenic abscess is a rare complication of thalassemia major. In this paper we report a 10-year-old male thalassemic child with splenic abscess. He presented with high-grade fever, abdominal pain and tender splenomegaly. The diagnosis was confirmed by ultrasonography and computerized tomography scan of the abdomen. The patient underwent emergency splenectomy.- - - - - - - - - - ranking = 32.863811702479keywords = abdominal pain (Clic here for more details about this article) |
15/103. Paraesophageal bronchogenic cyst associated with multiple epithelial splenic cysts.BACKGROUND: Bronchogenic cysts are rare congenital cystic lesions of foregut origin. They are the result of abnormal budding of the primitive tracheobronchial tube. Nonparasitic, true splenic cysts are another rare entity that might occur as incidental findings but may lead to deleterious courses in case of ruptures. CASE REPORT: We report here the first case of the uncommon association of a paraesophageal bronchogenic cyst and multiple primary splenic cysts in a 23-year-old woman suffering from dysphagia and chest pain. Successful complete resection of the paraesophageal cyst was performed using an abdominal, transhiatal approach and splenic cysts were subjected to organ-preserving TA stapler resection. CONCLUSION: Thus far there is no proof or genetic indication for a direct association of bronchogenic cysts and multiple splenic cysts, however, the uncommon coincidence of both lesions in our patient might suggest a common origin. Difficulties in preoperative diagnosis, histopathological characteristics and surgical treatment modalities are presented.- - - - - - - - - - ranking = 0.16666666666667keywords = chest (Clic here for more details about this article) |
16/103. Splenic hydatidosis complicated by a splenothoracic fistula: report of a case.The intrathoracic rupture of a splenic hydatid cyst is very unusual. We report herein the case of a 29-year-old man who presented with a left-sided pleural effusion associated with fever and chest pain. The patient underwent laparotomy and splenectomy en bloc with a portion of gastric wall and diaphragm, followed by irrigation of the pleural cavity with a hypertonic solution through a phrenotomy. His outcome was favorable and there was no recurrence at 2-year follow-up.- - - - - - - - - - ranking = 0.16666666666667keywords = chest (Clic here for more details about this article) |
17/103. Spontaneous splenic rupture following the administration of intravenous heparin: case report and retrospective case review.We report the case of a 40-year-old African-American female who presented to the Emergency Department with unstable angina. The patient, who had multiple risk factors for coronary artery disease, was admitted to the coronary care unit for cardiac work-up and management. Shortly after the intravenous administration of unfractionated heparin, she suffered the acute onset of upper abdominal pain and shock. A CT scan of the abdomen revealed splenic rupture with hemoperitoneum. The patient, who was managed surgically, had complete recovery before discharge. A review of systems and medical records revealed no obvious risk factors or other potential etiology for this rupture. We herein provide the characteristics of this rarely documented causal relationship between heparin and spontaneous splenic rupture and retrospectively review similar cases in the literature.- - - - - - - - - - ranking = 309.74031629752keywords = upper abdominal pain, abdominal pain (Clic here for more details about this article) |
18/103. Laparoscopic treatment of large true cysts of the liver and spleen is ineffective.True epidermal cysts of the liver and spleen are uncommon and it has been recommended that laparoscopic management is appropriate. Often these cysts are large and centrally located by the time they reach clinical significance thereby making complete excision difficult without major liver resection or splenectomy. Definitive therapy consists of drainage and complete resection of the cyst wall. Three patients presented with upper abdominal pain. Workup revealed large non-parasitic true cysts of the liver (one) and spleen (two). All were initially treated with laparoscopic resection of their cysts with the primary objective being organ preservation. They were followed with periodic ultrasound/CT scanning. The pathology report in all three cases demonstrated benign congenital epithelial cysts and the patients did well postoperatively. Despite meticulous dissection and marsupialization of the cysts all three patients experienced recurrence that necessitated further therapy. We conclude that laparoscopic surgery is inadequate in the management of true cysts of the liver and spleen unless complete removal of all cyst wall can be assured.- - - - - - - - - - ranking = 309.74031629752keywords = upper abdominal pain, abdominal pain (Clic here for more details about this article) |
19/103. Isolated hydatid disease of the spleen: CT findings in 4 patients and differential diagnosis.AIM: To report our experience with four cases of isolated hydatid disease of the spleen studied by spiral Computed tomography (CT) and to review the literature with special attention to the differential diagnosis with other focal lesions of the spleen. MATERIALS AND methods: The spiral CT images and clinical records of four patients (1 man, 3 women; age range 26-45 yrs) affected by isolated hydatid disease of the spleen were retrospectively evaluated. None of the patients had a history of hydatid disease. All the patients were evaluated by plain and enhanced spiral CT of the abdomen. All patients underwent preoperative chest X-ray and surgery; all surgical specimens were studied by histology. RESULTS: Spiral CT depicted all the hydatid lesions of the spleen. It showed the location, size, low density of their content without enhancement after iv contrast medium injection, the possible presence of daughter cysts, the appearance of the wall with calcifications, and excluded the presence of complications. The preoperative chest X-ray was negative for focal pulmonary lesions in all cases. pathology confirmed the diagnosis of hydatid disease in all cases. CONCLUSIONS: According to our results and to the literature, spiral CT plays an important role in the pre-surgical evaluation of patients with hydatid disease of the spleen, and provides useful information for differentiating the disease from other isolated cyst-like lesions of the spleen.- - - - - - - - - - ranking = 0.33333333333333keywords = chest (Clic here for more details about this article) |
20/103. hand-assisted laparoscopic splenectomy for a huge splenic cyst: operative technique and case report.We report the case of a huge splenic cyst that was successfully treated by hand-assisted laparoscopic splenectomy. A 17-year-old girl with a chief complaint of left-sided abdominal pain was admitted to our department for investigation of a splenic tumor. ultrasonography, computed tomography, and magnetic resonance imaging revealed a huge cystic lesion in the spleen measuring approximately 10 cm in diameter. hand-assisted laparoscopic splenectomy was safely performed to diagnose and treat the splenic tumor. The histologic diagnosis was an epithelial cyst of the spleen with no atypical cells in the cyst wall. hand-assisted laparoscopic splenectomy may be a good method of managing a huge splenic cyst that becomes symptomatic and potentially life-threatening through enlargement, rupture, and secondary infection.- - - - - - - - - - ranking = 32.863811702479keywords = abdominal pain (Clic here for more details about this article) |
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