1/4. 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 = radionuclide (Clic here for more details about this article) |
2/4. Splenic abscess caused by blastomyces dermatitidis.We have reported a case of fungal splenic abscess caused by blastomyces dermatitidis. Splenic abscess is an uncommon disorder, and fungus as the causative organism is rare. The diagnosis of splenic abscess can be rapidly made with radionuclide and CT scanning and ultrasonography. splenectomy with appropriate antifungal chemotherapy is the currently recommended therapy.- - - - - - - - - - ranking = 1keywords = radionuclide (Clic here for more details about this article) |
3/4. diagnosis of splenic rupture in malignant lymphoma using radionuclides.The case of a 59-year-old woman with malignant lymphoma who was investigated for fever and left upper quadrant abdominal pain is presented. A combined spleen/lung scan showed marked medial displacement of an enlarged spleen and a gallium scan showed increased splenic uptake consistent with lymphomatous infiltration. The diagnosis of prior splenic rupture with subphrenic hematoma was confirmed at laparotomy.- - - - - - - - - - ranking = 4keywords = radionuclide (Clic here for more details about this article) |
4/4. Radionuclide diagnosis of splenic rupture in infectious mononucleosis.Spontaneous splenic rupture is a rare but serious complication of infectious mononucleosis. Although radionuclide spleen imaging is a well accepted method for diagnosis of traumatic rupture, interpretation can be difficult in the setting of mononucleosis, as tears may be ill-defined and diagnosis hampered by inhomogeneous splenic uptake. Four proven cases of spontaneous rupture are presented, three of which illustrate these diagnostic problems.- - - - - - - - - - ranking = 1keywords = radionuclide (Clic here for more details about this article) |