1/54. Spontaneous rupture of splenic hamartoma: a case report.Splenic hamartomas are rare. The authors report a case of spontaneously ruptured splenic hamartoma in a 5-month-old boy. This rupture led to the death of the child. If abdominal pain is present and a mass is palpated, the splenic hamartoma should be managed surgically in an expeditious manner. There have been only two known previous reports of spontaneous rupture of splenic hamartoma in adults, but none in children.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/54. Delayed presentation of splenic rupture after colonoscopy.splenic rupture is a rare but potentially deadly complication of colonoscopy. We present the case of a 70-year-old male who presented with abdominal pain, initially stable, almost 2 days after colonoscopy. The patient's clinical status deteriorated shortly after abdominal CT scan identified splenic rupture.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
3/54. Rupture of the spleen associated with enterobacter cloacae.A 58-year-old male, with abdominal pain but no signs of sepsis, was admitted as a medical emergency. During hospitalization, spontaneous splenic rupture was diagnosed and splenectomy successfully performed. A smear revealed presence of enterobacter cloacae on the splenic surface; histopathology demonstrated granulocytous infiltration of the spleen.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
4/54. observation of splenic trauma: when is a little too much?A 12-year-old boy was treated conservatively for a grade II splenic laceration. On discharge, he was instructed to avoid contact sports, running, and strenuous physical activity. Thirty-eight days later, after diving off the side of a swimming pool, he had abdominal pain, nausea, and diaphoresis. On admission, he was hemodynamically unstable. Results of a diagnostic lavage showed gross blood. At laparotomy, a fractured spleen was found, and splenectomy was performed. He recovered without complication. This case questions the activity restrictions placed on patients with conservatively managed splenic trauma. Avoidance of only contact sports and heavy exertion may be inadequate.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
5/54. Delayed splenic rupture in a haemophiliac.We report an unusual case of post-traumatic delayed rupture of the spleen occurring in a 38-year-old man with haemophilia A. The time interval between injury and splenic rupture was at least 2 weeks. Although a rare event, the possibility of splenic rupture should always be considered in the differential diagnosis in patients with a bleeding disorder and abdominal pain, even when the patient does not initially give a history of abdominal injury. Radiological imaging, including ultrasound examination, is of great value in establishing the diagnosis. This case report includes a brief review of other similar cases.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
6/54. Spontaneous rupture of malarial spleen: two case reports and review of literature.malaria has long been among the most common diseases in the southeast Anatolia region of turkey. In 1992, 18676 cases were diagnosed in turkey, and Diyarbakir city had the highest incidence (4168 cases), followed by SanliUrfa city (3578 cases). malaria was especially common during 1994 and 1995, with 84345 and 82094 cases being diagnosed in these years, respectively. Spontaneous rupture of malarial spleen is rare. We saw two cases during 1998, which are reported herein. Both patients were male, and were receiving chloroquine treatment for an acute attack of malaria. One of the patients had developed abdominal pain and palpitations, followed by fainting. The other patient had abdominal pain and fever. Explorative laparotomy revealed an enlarged spleen in both patients. splenectomy was performed in both patients. We have identified 15 episodes of spontaneous rupture of the spleen in the English language literature published since 1961. Because of increased travel to endemic areas and resistance to antimalarial drugs, malaria is a major medical problem that is becoming increasingly important to surgeons worldwide. malaria is a particularly important problem in the southeast Anatolia region of turkey. Prophylactic precautions should be taken by tourists who travel to this region, especially during the summer.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
7/54. Rare complications of endoscopic retrograde cholangiopancreatography: two case reports.BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic procedure with several known risks. We present two rarely reported complications of ERCP and sphincterotomy: transverse mesocolon disruption with ischemic colitis and splenic rupture. RESULTS: The first patient, a 54-year-old female, presented one day following ERCP and stent revision for pancreas divisum. She presented with hypotension and abdominal distention. An abdominal computed tomography (CT) showed a ruptured spleen, which was confirmed on laparotomy. She had a complicated postoperative course and died of multiple organ failure. The second patient is a 56-year-old female who presented five days after ERCP and sphincterotomy with abdominal pain, abdominal wall ecchymosis, and decreasing hematocrit. Her evaluation included hospital admission and abdominal CT scan, which showed free fluid and a large hematoma in the transverse mesocolon. These findings were confirmed on laparotomy and a devascularized segment of bowel was resected. CONCLUSION: Only 6 cases of ERCP-related splenic injury have been reported in the literature. One additional report is available of a fatal splenic artery injury. No previous reports exist of a mesenteric hematoma resulting in bowel devascularization. Prompt evaluation and awareness of potential complications should help capture potentially life-threatening sequelae of ERCP.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/54. Post-traumatic intrasplenic pseudoaneurysms with delayed rupture: color Doppler sonographic and CT findings.Post-traumatic intrasplenic pseudoaneurysms are very rare in children. Since pseudoaneurysms may expand a splenic hematoma and cause delayed splenic rupture, early diagnosis and treatment are crucial. In this report, we describe the case of a 12-year-old boy with a delayed splenic rupture caused by a splenic hematoma containing 2 pseudoaneurysms. Abdominal sonography showed free intraperitoneal fluid and a mildly enlarged spleen with a large heterogeneous area occupying the upper half of the organ. Two anechoic lesions (15 and 4 mm) were seen inside the hematoma near the splenic hilum. color Doppler sonography demonstrated turbulent arterial flow within the lesions, suggesting pseudoaneurysms. On CT, the lesions enhanced simultaneously with the splenic artery in the arterial phase of contrast enhancement. CT also showed an intrasplenic arterial branch leading to the larger of the 2 pseudoaneurysms.- - - - - - - - - - ranking = 0.0037829674253218keywords = upper (Clic here for more details about this article) |
9/54. Rupture of the spleen in infective endocarditis.A patient had delayed spontaneous rupture of the spleen complicating infective endocarditis. In 20 other cases reported through 1973, the most common presentation was found to be left upper quadrant pain followed by signs of peritoneal irritation and cardiovascular collapse. Abdominal paracentesis consistently yields free blood or pus in the peritoneal cavity; blood replacement and emergency splenectomy may be lifesaving. The basic pathological mechanisms may be (1) rupture of a mycotic aneurysm into the splenic substance (2) rupture of a splenic abscess, and (3) rupture of a suppurating intrasplenic vessel with hematoma formation, subcapsular dissection, and delayed capsular tear.- - - - - - - - - - ranking = 0.0037829674253218keywords = upper (Clic here for more details about this article) |
10/54. Nonoperative treatment of splenic injury--report of a case.A case of subcapsular hematoma of the spleen in a 19-year-old soldier is presented, in which nonoperative treatment was chosen. More than 3 years postinjury the patient appears in excellent condition, with no palpable left upper abdominal mass palpable. The literature on nonoperative treatment of such injuries is discussed. The present authors remain in favor of operative treatment of proven cases of splenic injury.- - - - - - - - - - ranking = 0.0037829674253218keywords = upper (Clic here for more details about this article) |
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