1/6. Ruptured primary splenic angiosarcoma into the colon. Presentation as anal bleeding.A 71-year-old woman presented with a six month history of constipation and abdominal discomfort, with anal bleeding during the last days. ultrasonography and CT-scan of the abdomen showed a large heterogeneous mass that was located in the splenic region, but the nature and origin of the tumour could not be clearly established preoperatively. The clinical diagnosis was of abdominal tumour with colonic and splenic involvement, and a left hemicolectomy and splenectomy were performed. Pathologic examination revealed a primary angiosarcoma of the spleen with penetration and fistulization of the tumour into the large bowel. The patient received adjuvant radiation therapy, but she died of extensive metastastic disease from her primary angiosarcoma of the spleen nine months after surgery. In summary, splenic angiosarcoma is very difficult to diagnose preoperatively. This highly aggressive neoplasm has an overall poor prognosis, specially if it is associated with rupture and haemoperitoneum. As this case highlights, unusual forms of rupture may lead to atypical clinical presentations, increasing even more the difficulty in the diagnosis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/6. splenic rupture and infectious mononucleosis.infectious mononucleosis is an acute viral illness associated with a high incidence of splenomegaly, although the incidence of splenic rupture is low. When rupture occurs, the mortality has been significant, presumably, because a history of trauma is not present. The spleen may be vulnerable to injury due to the histopathologic changes that occur as a result of this illness. Essentially all patients with spontaneous rupture related to infectious mononucleosis have epigastric or upper abdominal pain. The diagnosis of splenic rupture may be confirmed in a variety of ways. In those patients who are hemodynamically stable, CT scan, ultrasound, or radionuclide scan may aid in establishing the diagnosis. Selective splenic angiography is very accurate but has been largely abandoned because of the invasive nature of the study. peritoneal lavage is efficacious in establishing the diagnosis in hemodynamically unstable patients. The treatment of choice, at this time, is splenectomy. Current interest in splenic salvage has resulted in reports of nonoperative therapy in stable patients and splenorrhaphy in one instance. Due to the extent of the histologic changes in the spleen, caution is urged in electing the conservative approach to this clinical situation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/6. Delayed rupture of the spleen in a patient with mandibular fracture.A case of blunt abdominal trauma with subsequent damage to and rupture of the spleen is presented. Clinical manifestations, diagnosis, and sequelae and complications of injury are discussed. This case report demonstrates the insidious nature of trauma to the spleen and the ultimate dangers of delayed rupture. Treatment and disposition of the case are discussed and recommendations for physical examination of the patient who has suffered trauma to the abdomen are outlined.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/6. Chronic myeloid leukemia: manifesting as spontaneous splenic rupture and terminating in megakaryoblastic transformation.We report a case of chronic myeloid leukemia with spontaneous splenic rupture as the initial presenting feature; there was a successful surgical outcome, but this case terminated in megakaryoblastic transformation. Results are reported based on morphological, immunological, cytochemical, ultrastructural, immunocytochemical studies, and in vitro liquid culture studies. The megakaryocytic nature of the blast cells was identified through the demonstration of platelet peroxidase activity by ultrastructural cytochemistry and the presence of platelet and megakaryocyte-specific antigen using monoclonal antibody, as well as the anti-factor viii antibody by immunocytochemical technique.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/6. The noninvasive diagnosis of intrathoracic splenosis using technetium-99m heat-damaged red blood cells.Intrathoracic splenosis results from the implantation of splenic tissue in the thoracic cavity following simultaneous rupture of the spleen and diaphragm. These implants may form mass lesions that lead to an extensive, costly, and invasive series of investigations, usually resulting in unnecessary surgery. The key to diagnosis is a high index of suspicion provoked by the history of a traumatic event, possibly in the distant past. This report emphasizes that because of its ability to demonstrate the functional nature of tissue, a definitive diagnosis can be made using heat-damaged Tc-99m RBCs without the need for surgical intervention.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/6. hemangioma of spleen with spontaneous, extra-peritoneal rupture, with associated splenic tuberculosis--an unusual presentation.We report a case of unusual presentation of a patient with hemangioma of the spleen. The patient had presented with recurrent gastric hemorrhage and significant weight loss, due to ruptured hemangioma of the spleen and associated splenic tuberculosis. The true nature of the lesions remained a diagnostic dilemma despite complete radiological workup and review of literature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |