1/12. Spontaneous splenic infarction secondary to diabetes-induced microvascular disease.splenic infarction is a clinical entity seldom encountered. The most frequent causes of splenic infarction include thromboembolic phenomena, hematologic malignant neoplasms, and vasculitides. We describe a patient who sustained splenic infarction secondary to diabetes-induced, small-vessel atherosclerotic disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/12. Massive splenic infarction in cirrhosis: report of a case with spontaneous disappearance of hypersplenism.A cirrhotic patient with massive splenic infarction is described. Celiac angiography showed normally opacified splenic artery and vein and a markedly enlarged spleen with large avascular zones. splenic infarction was associated with the spontaneous disappearance of a syndrome of hypersplenism. The spleen was surgically removed. Histological examination showed multiple thromboses of the small arterial and venous vessels. The cause of this infarct remained unclear.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/12. splenic infarction following laparoscopic Nissen fundoplication: management strategies.Techniques for mobilizing the greater curve of the stomach during laparoscopic Nissen fundoplication (LNF) include division of the short gastric vessels (SGV). The splenic artery and vein lie directly posterior to the proper plane of dissection. Uncontrolled bleeding during SGV division places the splenic vessels at risk for inadvertent injury or ligation. We report herein on 2 patients referred to our institution who had left upper quadrant pain and radiographic evidence of segmental splenic infarction (SI) that resulted from a peripheral splenic artery branch injury during LNF. Management strategies included a trial of conservative management and splenectomy for persistent symptoms or complications resulting from SI. Intense inflammation and adhesion formation making laparoscopic splenectomy difficult should be anticipated when operating on the infarcted spleen.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
4/12. splenectomy for massive splenic infarction unmasks paroxysmal nocturnal hemoglobinuria.Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disorder characterized by pancytopenia, hemolysis, and thrombosis. Abdominal vein thrombosis is a life-threatening manifestation of this disease. We present a patient with complete spleen necrosis due to thrombosis of the splenic vessels. After splenectomy, other causes of thrombophilia were excluded and the diagnosis of PNH was established. The patient was put on anticoagulation but despite the prophylactic international normalized ratio maintained over the last 18 months of follow-up, he had another episode of intrahepatic thrombosis which was treated with tissue plasminogen activator thrombolysis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/12. Acute pancreatitis with pseudocyst formation in a patient with polyarteritis nodosa.polyarteritis nodosa (PAN) is a term that includes patients with necrotizing inflammation of medium sized arteries, and excludes those with microscopic vessel involvement. Its manifestations are protean and include constitutional symptoms such as fever, malaise, weight loss, myalgia, peripheral neuropathy, rash, and gut and renal involvement. Although gastrointestinal manifestations have been noted in up to a third of patients with PAN, clinical presentation with pancreatic involvement has been reported only rarely. We describe a patient with PAN who developed acute pancreatitis with pseudocyst formation as well as infarcts in the spleen and liver.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/12. Functional deficiency of protein c associated with mesenteric venous thrombosis and splenic infarction.A 16-year-old girl had abdominal pain, hematemesis, and fever. Radiographic evaluation showed her to have an infarcted spleen and jejunum. Pathologic description revealed thrombi involving the vessels of both organs. A hypercoagulation evaluation of the patient and her family resulted in the diagnosis of hereditary protein c activity deficiency. She is unusual both in the diagnosis of protein c activity deficiency and in her appearance with mesenteric and splenic venous thrombosis. This appearance has not been previously reported in the literature and should be considered in the differential diagnosis of any thrombotic event, even in the face of a negative family history.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/12. hypertension in sickle cell disease.We report a young male with sickle cell trait who developed severe hypertension and splenic infarction soon after travel to a high altitude. hypertension persisted for three days after a diagnostic laparotomy. His blood pressure then continued to be normal over the next one and a half years. Red cell sludging in the small vessels of the kidney possibly activated the renin angiotensin system.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/12. Gastric and splenic infarction: a complication of intraarterial vasopressin infusion.Gastric and splenic infarction following intraarterial infusion of vasopressin in a patient's left gastric artery is reported. None of the previously described factors predisposing to infarction were present and the cause appears to have been hyperconstriction of vessels in response to vasopressin. Computed tomography (CT) scanning was used to confirm the extent of involvement.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/12. splenic artery ligation in distal splenorenal shunts.splenic artery ligation, a simple surgical procedure expected to decrease splenic flow and portal pressure in patients with cirrhosis of the liver, was performed concomitantly with a distal splenorenal shunt procedure in six patients and as the main surgical procedure in two patients. Immediate cessation of bleeding was achieved in the four patients in whom the splenic artery was ligated to reduce intraoperative bleeding. However, three of the seven patients with previous gastroesophageal hemorrhage rebled from various postoperatively. Symptoms of splenic infarction were observed in six patients, resulting in thrombosis of the splenic vein and/or of the distal splenorenal shunt in four patients and necessitating splenectomy in one. This incidence of thrombosis of the distal splenorenal shunt is much higher than the overall incidence of 5 per cent observed at our institution. It is thus concluded that the splenic artery should not be ligated in cirrhotic patients with patent distal splenorenal shunts, since splenic arterial collateral vessels have already been reduced by the gastric devascularization, an integral component of the distal splenorenal shunt.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/12. Enhanced rim around infarcted, traumatized spleen on computed tomographic scans: case report.Computed tomography is considered a reliable imaging technique when determining the extent of splenic injury. We present the case of a patient with a traumatic infarct of the spleen detected by computed tomographic scanning of the abdomen. During laparotomy there was an infarction of the spleen from a hilar injury in addition to bleeding from the splenic vein. We conclude that ongoing bleeding from the splenic hilar vessel can lead to a rim of enhancement around the spleen from contrast material. This should be taken into account when a decision is made for nonsurgical management.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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