11/54. Ruptured staphylococcal splenic abscess resulting in peritonitis: report of a case.A 50-year-old man presented with features of peritonitis of 2 days duration. The signs were more marked in the left upper abdomen. Investigations followed by a laparotomy showed a ruptured splenic abscess, the cause of which was not apparent. We herein present the case report of this unusual cause of peritonitis along with a relevant review of the literature.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
12/54. Fatal splenic arterial aneurysmal rupture associated with chronic pancreatitis.Splenic arterial aneurysms (SAA) are rare and are usually atherosclerotic and/or related to pregnancy. Because pregnancy is the most important predisposing factor, the strong predilection of SAA for women is not surprising. The authors report a case of SAA rupture in a man with chronic pancreatitis as the predisposing factor. A 56-year-old man with abdominal pain and hematemesis was resuscitated and underwent endoscopy, but he died 18 hours later of massive hematemesis before definitive surgery could be carried out. At autopsy, there was chronic pancreatitis with fibrous adhesions tethering the tail of the pancreas, spleen, and posterior wall of the stomach together. The SAA was indented into the posterior wall of the stomach, into which it had ruptured from without. He also had alcoholic cirrhosis but no esophageal varices or conventional gastric ulcers. Other important predisposing factors such as abdominal trauma, infective endocarditis, polyarteritis nodosa, and segmental medial arteriopathy were absent. Histologic examination confirmed the rupture of the SAA. The SAA had Monckeberg medial calcinosis but little evidence of atherosclerosis. The well-documented complications of acute and chronic pancreatitis include shock, abscess, pseudocyst formation, and duodenal obstruction. This report describes the rare complication of SAA rupture, which may be fatal.- - - - - - - - - - ranking = 264.34274673008keywords = abdominal pain (Clic here for more details about this article) |
13/54. pleural effusion with splenic rupture as manifestations of recurrence of sarcoidosis following prolonged remission.A 55-year-old man presented with a 3-week history of dry cough and left pleuritic chest pain with a new exudative pleural effusion. Sixteen years earlier, he was diagnosed with sarcoidosis presenting with hilar lymphadenopathy, erythema nodosum, mildly disturbed liver function tests and noncaseating granulomata on liver biopsy, with no evidence of pulmonary parenchymal disease. He was treated with prednisone and in recent years maintained at a low daily dose, until it was eventually discontinued two years prior to his present illness. There was no evidence of infection or malignancy, and the fluid resolved following treatment with naproxen. Three weeks later the patient presented with sudden onset of dyspnea and left chest pain. After starting intravenous heparin for suspected pulmonary emboli, the patient developed hemodynamic instability which was accompanied by abdominal tenderness and decreasing hematocrit. splenic rupture was diagnosed, and the patient underwent splenectomy. pathology specimens revealed a hemorrhagic infarct with subcapsular hematoma, and numerous noncaseating granulomata within the splenic tissue. This patient had recurrent sarcoidosis with two rare manifestations of the disease, 2 years after withdrawing low dose prednisone, given for a prolonged time. The possibility of reemergence of the disease in organs other than the organs involved in the initial presentation should always be considered in sarcoidosis.- - - - - - - - - - ranking = 0.63875310109951keywords = chest (Clic here for more details about this article) |
14/54. Spontaneous rupture of the spleen. An unusual complication of anticoagulant therapy.A 44-year-old man, who had been taking warfarin sodium because of a previous myocardial infarct, suddenly developed abdominal pain and signs of peritoneal irritation, requiring exploratory laparotomy. The spleen was ruptured. There were not any systemic diseases nor antecedents of trauma that could be considered predisposing factors for the apparently spontaneous rupture of the spleen. The only abnormality recorded was an elevated prothrombin time. Thus, a coagulopathy produced by the anticoagulants appeared to be the only possible predisposing factor for his splenic rupture.- - - - - - - - - - ranking = 264.34274673008keywords = abdominal pain (Clic here for more details about this article) |
15/54. Spontaneous splenic rupture in atypical (philadelphia chromosome negative) chronic myeloid leukaemia following blastic crisis.philadelphia chromosome negative and bcr/abl negative chronic myeloid leukaemia (CML) is an uncommon atypical CML. We describe a patient with this disorder who experienced an acute blastic transformation that resulted in rapid splenic enlargement and subsequent atraumatic splenic rupture. Clinically, spontaneous splenic rupture may be a difficult diagnosis to make and this case highlights the importance of considering atraumatic splenic rupture as a cause for unexplained abdominal pain in a patient with a haematological malignancy.- - - - - - - - - - ranking = 264.34274673008keywords = abdominal pain (Clic here for more details about this article) |
16/54. Hodgkin's disease presenting as spontaneous splenic rupture.Hodgkin's disease presenting as spontaneous splenic rupture is rare. A 46-year-old man with a 4-week history of fever, chills, and night sweats developed sudden abdominal pain and hypotension. At surgery, an enlarged, ruptured spleen with a nodular surface was found. Histologically, there was diffuse infiltration of the red pulp by mixed-cellularity Hodgkin's disease with patchy involvement of the white pulp. The histopathologic findings in the three previously reported cases are all dissimilar to this. These differences most likely represent rupture occurring at different stages of splenic infiltration by Hodgkin's disease.- - - - - - - - - - ranking = 264.34274673008keywords = abdominal pain (Clic here for more details about this article) |
17/54. Ruptured splenic abscess secondary to infectious mononucleosis.A 24-year-old woman with a recent diagnosis of infectious mononucleosis presented with fever and left upper quadrant pain. Abdominal computed tomography revealed a splenic abscess that at laparotomy was found to have ruptured. This case illustrates a rare cause of splenic abscess and a rare complication of infectious mononucleosis.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
18/54. Spontaneous splenic rupture.Spontaneous splenic rupture is a rare entity. It is usually associated with infectious, neoplastic, or hematologic diseases. Unlike traumatic splenic rupture, spontaneous rupture of the spleen is not often considered in the differential diagnosis of abdominal pain and can be easily confused with other abdominal pathology. Failure to consider splenic rupture can be catastrophic. We report a case of atraumatic splenic rupture in a patient with no underlying disease pathology. This illustrates the importance of keeping a broad differential in patients presenting with acute abdominal pain and should remind the physician to consider the diagnosis of spontaneous nontraumatic splenic rupture.- - - - - - - - - - ranking = 528.68549346017keywords = abdominal pain (Clic here for more details about this article) |
19/54. Splenic complications in malaria: report of two cases from turkey.malaria is still a major health problem in turkey, where plasmodium vivax malaria is endemic. Spontaneous rupture of the spleen is an important and life-threatening complication and occurs in up to an estimated 2 % of cases. Hence the small number of case reports suggests under-reporting or underdiagnosis. review articles have reported only 18 malaria cases with spontaneous splenic rupture in the English language literature since 1960. Two cases of P. vivax malaria with splenic complications are reported here. One of them showed signs and symptoms of acute abdominal pain, then splenic rupture occurred.- - - - - - - - - - ranking = 264.34274673008keywords = abdominal pain (Clic here for more details about this article) |
20/54. Delayed splenic rupture: understanding the threat.The spleen is the most commonly injured organ in blunt abdominal trauma and is also frequently injured as a result of penetrating trauma to the left torso or upper abdomen. Most splenic injuries manifest at the moment of injury with symptoms of acute intraperitoneal hemorrhage and shock. Delayed rupture of the spleen after trauma is an unusual outcome but one that exists. In delayed splenic rupture (DSR) there may be an asymptomatic period between initial injury and the appearance of signs of internal hemorrhage. Close evaluation of the degree of splenic injury by utilizing the Splenic Injury Scale as proposed by the American association for the Surgery of Trauma (AAST), the presence of subcapsular hematoma, pseudocyst, or pseudo aneurysm all must be entertained. It is imperative that the practitioner caring for this population have a working knowledge of the risk factors, diagnostic studies and interventions needed to promptly intervene thus reducing the morbidity and mortality associated with the splenic trauma and subsequent delayed rupture.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
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