scholarly journals The Importance of Recognizing Wandering Spleen as a Cause of Recurrent Acute Pancreatitis

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Vennis Lourdusamy ◽  
Dhrumil Patel ◽  
Ramon Docobo ◽  
Shyamanand Tantry ◽  
Dennis Lourdusamy ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Rare Condition ◽  
Young Female ◽  
Wandering Spleen ◽  
Recurrent Acute Pancreatitis ◽  
Splenic Torsion ◽  
Palpable Mass ◽  
Rare Manifestation ◽  
Life Threatening ◽  
Inferior Quadrant

Wandering spleen, as its name suggests, is a rare condition where the spleen wanders in the abdomen and is most commonly found in the inferior quadrant as a palpable mass. It can have varying presentations and commonly presents as splenic torsion and very rarely as acute pancreatitis. It is imperative not to miss this diagnosis as it can lead to life-threatening complications in the form of splenic torsion/infarction. Here we describe a rare manifestation of wandering spleen where a young female presented with recurrent episodes of acute pancreatitis.

scholarly journals DIAGNOSIS AND MANAGEMENT OF PANCREATIC MUCINOUS CYSTADENOMA

2015 ◽  
Vol 2 (2) ◽  
pp. 63-67
Author(s):  
Lidia Ladea ◽  
Andreea Nicoleta Costache ◽  
F. C. Blăjuț ◽  
V. Tomulescu
Keyword(s):  
Acute Pancreatitis ◽  
Therapeutic Option ◽  
Malignant Lesion ◽  
Mucinous Cystadenoma ◽  
Rare Condition ◽  
The Body ◽  
Pancreatic Cysts ◽  
Benign Tumors ◽  
Recurrent Acute Pancreatitis ◽  
Mucinous Cystadenomas

Pancreatic mucinous cystadenomas (MCAs) are considered to be benign tumors with a high risk of malignant progression. The pancreatic mucinous cystadenoma is considered to be a rare condition that may lead to pancreatic cancer when not surgically resected. MCAs represent 9.7% of all neoplastic pancreatic cysts. The male:female ratio of MCAs is 1:10. The condition appears mostly in women, mean age in the 5th decade. The cyst is restricted by a fibrous capsule of variable consistency and has usually no communication with the pancreatic ductal system. The MCAs are located mostly in the body or tail of the pancreas. The MCAs located in the head of the pancreas are more likely to be malignant. Complete surgical resection is the recommended therapeutic option. We present a case of a 59-year-old female patient admitted in the Departemt of Surgery and Liver Transplatation of Fundeni Clinical Institute for recurrent episodes of acute pancreatitis. After a thorough investigation was performed, the CT-examination showed a pancreatic mass, located in the tail, measuring 30/40mm. Because the CT aspect was specific for a cystic-like lesion, surgery was recommended. The patient underwent a laparoscopic caudal splenopancreatectomy with a favorable postoperative evolution. The particularity of the case comes from the patient’s clinical presentation, with recurrent acute pancreatitis and the imagistic aspect (ultrasound and CT) that initially suggested a pseudocystic-like lesion, but the elevated CA 15-3 and further elaborated examinations indicated a possible malignant lesion.

scholarly journals Acute abdomen due to an infarction of wandering spleen: case report

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Ragheb Assaf ◽  
Baraa Shebli ◽  
Ayham Alzahran ◽  
Ahmad Rami Rahmeh ◽  
Ali Mansour ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chronic Pain ◽  
Acute Abdomen ◽  
Rare Condition ◽  
Wandering Spleen ◽  
Ectopic Spleen ◽  
Threatening Condition ◽  
Life Threatening ◽  
Displaced Spleen

Abstract Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all spleen ligaments that fixate the spleen in the left upper quadrant. Many different terms refer to wandering spleen like dislocated spleen, ectopic spleen and displaced spleen. We report in this case a 13-year-old Syrian girl presented to the emergency department complaining of acute generalized abdominal pain with fever, anorexia and vomiting started 2 days prior to presentation. A splenectomy was performed, with uneventful postsurgical follow-up. Wandering spleen is prone to torsion and infarction resulting in acute abdomen and a life-threatening condition with high mortality rate reaching 50%. We advise the investigation of any recurrent episodes of chronic pain keeping up within mind this diagnosis.

scholarly journals Wandering Spleen - A Possible Cause of Adrenal “Mass” - Case Report

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Slavica Markovic ◽  
Milan Paunovic ◽  
Biljana Vuletic ◽  
Zorica Raskovic ◽  
Gordana Kostic ◽  
...  
Keyword(s):  
Negative Attitude ◽  
Rare Condition ◽  
Good Health ◽  
Anterior Wall ◽  
Wandering Spleen ◽  
Anatomical Location ◽  
Ectopic Spleen ◽  
Life Threatening ◽  
Low Incidence ◽  
The Right

Abstract Wandering spleen is a very rare clinical condition characterized by spleen absence in the normal anatomical location in the upper left quadrant of the abdomen and its presence at another location in the abdomen or pelvis. The ectopic spleen is extremely rare in children, where its increased mobility is the result of a congenital disturbance of the fixation for the anterior wall due to the absence or weakness of the supporting ligaments. Wandering spleen is usually asymptomatic, but its torsion is possible, as well as infarction or rupture which demand an urgent diagnosis and surgical treatment. The diagnosis of wandering spleen can easily be overlooked due to low incidence and insufficient clinical experience, which multiplies patient’s risk from life-threatening conditions. We present a case of wandering spleen in an 11-year-old girl with acute abdominal pain, which after ultrasound examination raised suspicion on the right adrenal gland tumor. Additional diagnostics verified an ectopic spleen in the right adrenal box, after which the recommended preventive splenopexy was seriously considered. Due to the fixation of the vital spleen in the new position, but also the negative attitude of the parents towards the surgical intervention, clinical monitoring was selected, with exclusion of intense physical activity that carries the risk of traumatization of the spleen. As the girl has been in good health for over 3 years and without symptoms, we consider that the selection of conservative access although difficult, was correct. We hope that our experience in treating wandering spleen in girls will increase the number of valid facts about this rare condition.

scholarly journals A Redo of Duct-To-Mucosa Pancreaticojejunostomy for Recurrent Acute Pancreatitis Due to Intra-Pancreatic Lithiasis and Anastomotic Stricture: Is This a Reasonable Strategy?

2020 ◽  
pp. 1-2
Author(s):  
Lucas McCormack ◽  
Cobos CM ◽  
Laxague F ◽  
Lucas McCormack ◽  
Ramallo Darío
Keyword(s):  
Acute Pancreatitis ◽  
Anastomotic Stricture ◽  
Rare Condition ◽  
Long Term Results ◽  
Biliary Strictures ◽  
Recurrent Acute Pancreatitis ◽  
Pancreatic Lithiasis ◽  
Long Term Survivors ◽  
Partial Pancreatoduodenectomy

Few studies have examined the postoperative long-term complications after partial pancreatoduodenectomy and there are mainly focused in the presence of biliary strictures. The occurrence of intra-pancreatic lithiasis secondary to the presence of late stenosis of the duct-to-mucosa pancreaticojejunostomy is an extremely rare condition. We observed that the late occurrence of a pancreaticojejunostomy stricture could be a potential cause for acute pancreatitis in long-term survivors following partial pancreatoduodenectomy. The importance of this report is to emphasize that the strategy of a redo of this difficult anastomosis is a very challenging abdominal operation but provides excellent early and long-term results

Hypertriglyceridemia: An Infrequent, Difficult-to-predict, Severe Metabolic and Vascular Problem Associated with Estrogen Administration

2020 ◽  
Vol 18 (3) ◽  
pp. 254-261
Author(s):  
Thomas F. Whayne
Keyword(s):  
Acute Pancreatitis ◽  
Severe Side Effect ◽  
Recurrent Acute Pancreatitis ◽  
Postmenopausal Symptoms ◽  
Severe Hypertriglyceridemia ◽  
Short Period ◽  
Cv Disease ◽  
The Right ◽  
And Control ◽  
Transdermal Route

Supplementary estrogen plays important roles for female patients as convenient birth control, relief of postmenopausal symptoms, and in the management of other selected problems. However, as is the case for essentially all medications, there are side effects. Short of a major pulmonary embolus, the most severe side effect of estrogen would appear to be sporadic, rare, and severe hypertriglyceridemia associated with acute pancreatitis. The occurrence of this fortunately rare problem usually happens in the presence of some preexisting and usually mild increase in triglycerides (TG). A case of chronic and severe recurrent acute pancreatitis is described in the introduction and the management was complete estrogen avoidance. Started close to menopause and continued for a relatively short period, estrogens may have some cardiovascular (CV) benefit but the general recommendation is not to prescribe them for CV disease prevention. Estrogens may contribute to decreased diabetes mellitus (DM) risk and control. Administration of estrogens by the transdermal route may decrease some problems such as venous thromboembolism (VTE) and elevation of TG. Administration of estrogen in the right situation brings significant benefit to the female patient but skillful, careful, and knowledgeable use is essential.

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

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