1/8. Nonoperative treatment of splenic rupture in malaria tropica: review of literature and case report.In many parts of the world malaria still is a major medical problem. Heavy international and transcontinental traveling carries malaria to non-endemic areas. Practicing physicians must be aware of the common, but also the rare and severe complications of malaria. During malaria changes in splenic structure can result in asymptomatic enlargement or complications such as hematoma formation, rupture, hypersplenism, ectopic spleen, torsion, or cyst formation. An abnormal immunological response may result in massive splenic enlargement. Spontaneous rupture of the spleen is an important and life threatening complication of plasmodium vivax infection, but is rarely seen in plasmodium falciparum malaria. The ability to properly diagnose and manage these complications is important. spleen-conserving procedures should be the standard whenever possible especially in patients with a high likelihood of future exposure to malaria.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. 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 = 1keywords = physician (Clic here for more details about this article) |
3/8. Nonoperative management of spontaneous splenic rupture in infectious mononucleosis: the role for emerging diagnostic and treatment modalities.infectious mononucleosis (IM) is a self-limiting lymphoproliferative disorder affecting teenagers and young adults. splenomegaly is a common manifestation of IM and results in a compromised organ that may rarely rupture spontaneously, with significant morbidity and mortality. The IM spleen should be protected from even minor trauma. Although traditional management of spontaneous splenic rupture in IM has been splenectomy, the role of nonoperative management is evolving. The advent of endovascular interventional modalities has augmented the physician's armamentarium in managing these patients nonoperatively. We report a case of spontaneous splenic rupture in a patient with IM managed conservatively with the aid of splenic angiography. The option of arteriography, with or without embolization, should be considered in the management of all patients with spontaneous splenic rupture in the setting of IM.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/8. How to manage splenic rupture during major liver resection?Spontaneous splenic rupture is a rare but life threatening complication of major liver resection with only five reported cases during major liver resection under hepatic vascular occlusion. We report two cases of splenic rupture during liver resection including the first case during portal triad clamping. In both patients, the hemorrhage was stopped by removing the vascular clamp. A splenectomy was performed in both patients and liver resection was completed under vascular clamping without complications. Although very rare, physicians should be aware of the possibility of splenic rupture during liver resection because instead of increasing vascular occlusion, clamp removal usually stops the hemorrhage.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/8. Spontaneous rupture of the spleen: a case report and literature review.Traumatic rupture of the spleen has been well described in the medical literature and is found in approximately 30% of patients undergoing surgery for blunt abdominal injury. Atraumatic splenic rupture is described much less often. A case of atraumatic rupture of an enlarged spleen is described. The etiology of spontaneous rupture of the spleen in this case could not be determined. The patient was seen and discharged twice from the emergency department; the diagnosis was made at emergency laparotomy three days after subsequent admission. This case should remind the emergency physician that nontraumatic splenic rupture should be considered in the differential diagnosis of unexplained acute left upper quadrant abdominal pain.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/8. Tight-fitting garments as counterpressure devices.A case of traumatic splenic rupture in a hemodynamically stable elderly woman is presented. The patient decompensated almost immediately following the removal of a tight-fitting girdle. The implications of recognizing garments as potential counterpressure devices in emergency management are discussed. Emergency physicians are cautioned to carefully explore and reevaluate patients after the removal of tight-fitting garments.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/8. Neonatal death following in utero traumatic splenic rupture.Perinatal death due to maternal injury is unusual unless associated with extensive maternal trauma or death. An unusual case of neonatal death due to in utero traumatic splenic rupture in the absence of significant maternal injury is presented. The case alerts physicians responsible for neonatal care to the existence of treatable causes of neonatal distress following maternal trauma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/8. diagnosis of spontaneous splenic rupture with emergency ultrasonography.Rapid evaluation of the hypotensive patient in the emergency department is essential. The availability of ultrasonography in the ED, performed by emergency physicians and surgeons, has made it easier to evaluate the hypotensive trauma patient. We describe a 44-year-old man transferred to our institution from a community hospital for evaluation of syncope and hypotension with no obvious cause. On arrival the patient began to complain of slight lower abdominal pain. The patient's physical examination revealed minimal abdominal tenderness. A rapid ultrasound examination performed at bedside revealed the presence of intraperitoneal fluid. Examination of the spleen suggested likely rupture. The patient was promptly taken to surgery for splenectomy and discharged home in 4 days.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |