scholarly journals Diagnosis and Treatment of Atraumatic Splenic Rupture: Experience of 8 Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Jian Liu ◽  
Yanyu Feng ◽  
Ang Li ◽  
Chunqing Liu ◽  
Fei Li
Keyword(s):  
Splenic Rupture ◽  
Diagnosis And Treatment ◽  
Etiological Factors ◽  
Contrast Enhanced ◽  
Life Threatening ◽  
Grade Ii ◽  
Atraumatic Splenic Rupture ◽  
Total Splenectomy ◽  
Traumatic Splenic Rupture ◽  
Enhanced Computed Tomography

Atraumatic splenic rupture (ASR) is rare but life threatening. In this study, we retrospectively described our experience on the diagnosis and treatment of 8 patients (male: 6; female: 2; mean age: 49.6) with ASR. ASR accounted for 3.2% (8/251) of the splenic ruptures. The clinical presentation of ASR was similar to traumatic splenic rupture (TSR). The sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in ASR diagnosis was 57.1% and 85.7%, respectively. According to the classification of the American Association for the Surgery of Trauma (AAST), 2 cases were classified as grade II splenic ruptures, 4 cases were classified as grade III ruptures, 1 case was classified as grade IV rupture, and 1 case was not classified. All the spleens became swollen, and hematomas were observed in 6 patients. Total splenectomy was recommended in most cases. At least 62.5% (5/8) of the patients with 7 etiological factors belonged to “atraumatic-pathological splenic rupture.” Local inflammation and cancer were the most common etiological factors.

scholarly journals Atraumatic Splenic Rupture in a SARS-CoV-2 Patient: Case Report and Review of Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marcello Agus ◽  
Maria Elena Ferrara ◽  
Paola Bianco ◽  
Cristina Manieli ◽  
Paolo Mura ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splenic Rupture ◽  
Delayed Diagnosis ◽  
Caucasian Woman ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture ◽  
Rupture Of The Spleen ◽  
Delay Of Diagnosis ◽  
Possible Cause

Splenic rupture in the absence of trauma or previously diagnosed disease is rare. Due to the delay of diagnosis and treatment, this is a potentially life-threatening condition. We report a case of atraumatic splenic rupture in a SARS-CoV-2 patient. This report is of particular interest as it first identifies SARS-CoV-2 infection as a possible cause of spontaneous rupture of the spleen. A 46-year-old Caucasian woman presented at the emergency department pale and sweaty, complaining of syncopal episodes, tachycardia, hypotension, diarrhea, intense abdominal pain, diffuse arthromyalgia, and fever from the day before. RT-PCR was positive for SARS-CoV-2 infection. CT scan demonstrated extensive hemoperitoneum due to rupture of the splenic capsule. The patient required an emergency open splenectomy because of an unresponsive hemorrhagic shock. At the end of the surgery, the patient was relocated to a COVID-19 dedicated facility. COVID-19 is a new disease of which all manifestations are not yet known. Inpatients affected by SARS-CoV-2 infection with abdominal pain and spontaneous splenic rupture should be considered to avoid a delayed diagnosis.

Laparoscopic Splenectomy for Atraumatic Splenic Rupture

2011 ◽  
Vol 96 (1) ◽  
pp. 87-89 ◽  
Author(s):  
Ugo Grossi ◽  
Antonio Crucitti ◽  
Gerardo D'Amato ◽  
Andrea Mazzari ◽  
Pasquina M. C. Tomaiuolo ◽  
...  
Keyword(s):  
Laparoscopic Splenectomy ◽  
Splenic Rupture ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Life Saving ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture ◽  
Prompt Diagnosis

Abstract Atraumatic splenic rupture (ASR) is a rare clinical entity. Several underlying benign and malignant conditions have been described as a leading cause. We report on a case of ASR in a 41-year-old man treated with laparoscopic splenectomy. Considering ASR as a life-threatening condition, a prompt diagnosis can be life saving.

scholarly journals Ultrasound Detection of the Aquarium Sign at the Bedside

2020 ◽  
Author(s):  
Mihiro Kaga ◽  
Emi Yamashita ◽  
Takeshi Ueda
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Test Results ◽  
Mesenteric Ischaemia ◽  
Contrast Enhanced ◽  
Life Threatening ◽  
Hepatic Portal ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
The Relationship

Objectives: The aquarium sign is the name given to a large quantity of bubble-like echoes that suggests the presence of hepatic portal venous gas (HPVG). Few studies in the literature have addressed the relationship between the aquarium sign and HPVG. In some cases, HPVG can only be detected using ultrasonography. HPVG can be observed in a variety of conditions, including those that require emergency surgery, such as acute mesenteric ischaemia (AMI). Therefore, it is important to identify the presence of HPVG as soon as possible.  Materials and methods: We report a case of the aquarium sign, where bubble-like echoes flowed from the right atrium towards the right ventricle, which was identified using bedside cardiac ultrasonography as part of a point-of-care ultrasound test. Results: This aquarium sign finding led to the diagnosis of AMI, which was confirmed using contrast-enhanced computed tomography (CT).  Conclusion: The aquarium sign is a useful finding suggestive of HPVG and mesenteric ischaemia, which can be rapidly and easily observed using bedside cardiac ultrasonography. However, there are very few reports on the aquarium sign. The inability of other more cumbersome diagnostic imaging modalities, such as CT and magnetic resonance imaging, to detect HPVG emphasizes the utility and convenience of detecting the aquarium sign using bedside ultrasonography. This technique can lead to early detection of life-threatening diseases as well as improve the prognosis for patients. The diagnostic implications of the aquarium sign for HPVG are still unclear and require further research.

scholarly journals SURG-31. SPECTROSCOPIC MRI TO GUIDE BIOPSY OF LOWER GRADE GLIOMAS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi246-vi246
Author(s):  
Jeffrey Olson ◽  
Brent Weinberg ◽  
Saumya Gurbani ◽  
Karthik Ramesh ◽  
Eduard Schreibmann ◽  
...  
Keyword(s):  
Imaging Method ◽  
Lower Grade ◽  
High Grade ◽  
Mri Imaging ◽  
Contrast Enhanced ◽  
High Resolution Mri ◽  
Histopathologic Diagnosis ◽  
Neuronavigation System ◽  
Life Threatening ◽  
Grade Ii

Abstract Primary brain tumors are serious and life-threatening; thus, accurate histopathologic diagnosis is critical for determining the proper clinical treatment regimen. Grade II/III gliomas (lower grade gliomas, or LGGs), including astrocytomas and oligodendrogliomas, are heterogeneous and potentially contain low- and high-grade areas within the same tumor. Therefore, it is critical to target biopsies to the most aggressive portion of the tumor to avoid tumor under-grading and under-treatment. While glioblastomas are typically targeted based on contrast-enhanced MRI, LGGs have little contrast enhancement to define targets for biopsy treatment guidance. Spectroscopic MRI (sMRI) is a high-resolution MRI imaging method which allows for detection of metabolic abnormalities such as choline and NAA in the entire brain without injection of a contrast agent. We have previously evaluated the relationship between sMRI Cho/NAA ratios and tumor infiltration in surgical specimens from high grade gliomas, demonstrating a strong correlation between sMRI results and glioma infiltration. We also used the location information to correlate sMRI data to genetic and histologic biomarkers (such as 1p19q, IDH, and MGMT). An IRB-approved pilot study to obtain sMRI prior to stereotactic biopsy has been done in 20 non-enhancing LGG cases. Patients with a suspected LGG diagnosis underwent sMRI at the time of their surgical planning MRI. sMRI images were then registered to the T1w-CE and T2/FLAIR images and imported into the Stealth neuronavigation system for biopsy planning. We found that all astrocytomas (regardless of grades) showed strongly elevated Cho/NAA, while the LGGs were hardly delineated on T1w and T2/FLAIR. We found that pathology-confirmed grade II oligodendroglioma do not have choline elevation; however, NAA was mildly decreased, myo-inositol was elevated, and creatine (Cr) was mildly elevated. sMRI is a useful tool to improve biopsy targeting in LGG patients by ensuring that the highest risk regions are sampled.

Atraumatic splenic rupture in chronic pancreatitis with successful embolization

2020 ◽  
Vol 21 (2) ◽  
pp. 58-68
Author(s):  
Anooja Abdul Salam ◽  
Ben Pearch ◽  
Lisa Sorger
Keyword(s):  
Chronic Pancreatitis ◽  
Splenic Artery ◽  
Splenic Rupture ◽  
Early Recognition ◽  
Hypovolemic Shock ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture

Atraumatic splenic rupture is uncommon but it is a life threatening condition because of hypovolemic shock. Early recognition and treatment are the keys to asuccessful outcome. We report a case of atraumatic splenic rupture secondary to chronic pancreatitis treated successfully by splenic artery embolization.

scholarly journals Spontaneous and Traumatic Splenic Rupture: Retrospective Clinical, B-Mode and CEUS Analysis in 62 Patients

2018 ◽  
Vol 04 (01) ◽  
pp. E30-E34 ◽  
Author(s):  
M. Rosling ◽  
C. Trenker ◽  
A. Neesse ◽  
C. Görg
Keyword(s):  
Clinical Data ◽  
Clinical Characteristics ◽  
Splenic Rupture ◽  
Tertiary Referral ◽  
Course Of Disease ◽  
Tertiary Referral Center ◽  
Contrast Enhanced ◽  
Patients At Risk ◽  
Traumatic Splenic Rupture ◽  
Sonographic Pattern

Abstract Introduction Both B-mode ultrasound and contrast-enhanced ultrasound (CEUS) are well established procedures when diagnosing traumatic splenic ruptures (TSR). To date, there are no data about CEUS patterns in spontaneous splenic ruptures (SSR). It remains unknown whether TSR and SSR differ with respect to clinical characteristics, B-mode and CEUS characteristics. Patients and Methods Between 12/2003 and 2/2010, n=33 SSRs and n=29 TSRs were diagnosed in a tertiary referral center. All patients were examined with B-mode and CEUS, and clinical data and the outcome were retrospectively analyzed. Results Patients with SSR were significantly older than patients with TSR (62 years vs. 44 years; p=0.01). The 4-week mortality was significantly higher in SSR than in TSR (36% vs. 0%; p=0.001). No differences between the grading of TSR and SSR could be shown in B-mode or in CEUS. Notably, CEUS was significantly superior to B-mode with respect to the grading of splenic ruptures (p=0.01). Therefore, therapeutic management was influenced by CEUS. Conclusion There are differences between SSR and TSR, especially concerning clinical data (age, course of disease and mortality). Regarding the sonographic pattern, SSR and TSR show identical grading. When splenic rupture is suspected, CEUS should always be performed to identify patients at risk who require interventional procedures.

scholarly journals Proximal Descending Thoracic Aortic Pseudoaneurysm Secondary to Pott's Spine

Aorta ◽  
2020 ◽  
Vol 08 (02) ◽  
pp. 035-037 ◽  
Author(s):  
Irappa Madabhavi ◽  
Malay Sarkar ◽  
Chidanand Chauhan ◽  
Mitul Modi
Keyword(s):  
Vertebral Osteomyelitis ◽  
Thoracic Vertebrae ◽  
Aortic Pseudoaneurysm ◽  
Contrast Enhanced ◽  
Life Threatening ◽  
History Of ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Very High ◽  
Antituberculous Chemotherapy

AbstractTuberculous pseudoaneurysm of the descending thoracic aorta is quite rare, life-threatening, and fatal if not diagnosed in time. This lesion exposes patients to a very high risk of unpredictable rupture. We describe a case of tuberculous pseudoaneurysm of the aorta in association with tuberculosis of the spine (Pott's spine). A 73-year-old man presented with a 2-month history of back pain. Chest roentgenography and contrast-enhanced computed tomography showed a descending thoracic aortic pseudoaneurysm with destruction of the fourth and fifth thoracic vertebrae (T4-T5). We suspected that the pseudoaneurysm was due to direct extension of tuberculous vertebral osteomyelitis. The patient was managed with antituberculous chemotherapy. The post–antitubercular therapy course was uneventful and he remained well 12 months after completion of treatment.

scholarly journals Atraumatic splenic rupture in chronic pancreatitis with successful embolization

2020 ◽  
pp. 58-68
Author(s):  
Anooja Abdul Salam ◽  
Ben Pearch ◽  
Lisa Sorger
Keyword(s):  
Chronic Pancreatitis ◽  
Splenic Artery ◽  
Splenic Rupture ◽  
Early Recognition ◽  
Hypovolemic Shock ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture

Atraumatic splenic rupture is uncommon but it is a life threatening condition because of hypovolemic shock. Early recognition and treatment are the keys to asuccessful outcome. We report a case of atraumatic splenic rupture secondary to chronic pancreatitis treated successfully by splenic artery embolization.

scholarly journals Splenic Rupture in a COVID-19 Patient – Case Report

2021 ◽  
Author(s):  
Anna C. Crowley ◽  
Raul R. Magadia ◽  
Arianna B. Lanpher
Keyword(s):  
Splenic Rupture ◽  
Early Recognition ◽  
Vascular Occlusion ◽  
Abdominal Pressure ◽  
Life Threatening ◽  
Splenic Disease ◽  
Traumatic Splenic Rupture ◽  
Stage Renal Disease ◽  
End Stage ◽  
High Index Of Suspicion

Background: It is well known that Coronavirus disease 2019 (COVID-19) causes coagulation changes, requiring frequent monitoring for potential sequelae such as myocardial infarction and stroke. Non-traumatic splenic rupture is a rare and poorly understood occurrence in the clinical setting. Possible causes of nontraumatic splenic rupture include neoplasm, infection, inflammatory disease, iatrogenic and mechanical causes. Furthermore, increased intrasplenic tension, increased abdominal pressure, and thrombotic vascular occlusion are three possible mechanisms. The Case: We report a case of splenic rupture in a COVID-19 patient. Our patient was a 52 year old black man, presenting with diarrhea and moderate dyspnea, who was found to be COVID-19 positive. He had a past medical history significant for end-stage renal disease, chronic anemia, and aortic valve replacement. In an otherwise uneventful, 7-day hospital course, the patient’s stay abruptly resulted in a nontraumatic splenic rupture and demise. In this report, we have evaluated the likelihood of COVID-19 causing splenic rupture in a patient with no prior splenic disease. Conclusion: This case highlights the possibility of splenic rupture in otherwise normally recovering COVID-19 patients, particularly in the presence of comorbid conditions of renal failure and anticoagulation, with increased abdominal pressure during routine defecation. This information may assist in furthering the pathophysiology of COVID-19 and its life-threatening complications. In patients with COVID-19, non-traumatic splenic rupture should be considered as one of the differential diagnosis in patients who present with abdominal pain and early recognition of the same, owing to a high index of suspicion, can be lifesaving.

POST-SPLENECTOMY INFECTION IN INFANTS AND CHILDREN

PEDIATRICS ◽  
1960 ◽  
Vol 25 (6) ◽  
pp. 941-951
Author(s):  
Tom W. Robinson ◽  
Phillip Sturgeon
Keyword(s):  
Splenic Rupture ◽  
Severe Infection ◽  
Underlying Disease ◽  
Thrombocytopenic Purpura ◽  
Median Period ◽  
Life Threatening ◽  
Severe Infections ◽  
Total Splenectomy ◽  
Very High ◽  
In Infants And Children

Fatal or life-threatening infection occurred in 13 members of a post-splenectomy population of 110 individuals followed for a median period of 6 years. Division of the population into two groups, one group predisposed to infection by the basic disease and/or the treatment which led to splenectomy and another non-predisposed group, revealed a distinct difference in the hazard. The non-predisposed group of 63 individuals had only one severe infection; this experience does not suggest risk of a very high order. Our Experience combined with that of others reporting cases in this category, provides a total splenectomy population of 205 with but two severe infections. It is evident that splenectomy carries a very low risk of post-operative infection when done over the age of 6 months for the generally accepted indications of splenic rupture, congenital spherocytic anemia, and idiopathic thrombocytopenic purpura. In the 47 individuals in this study predisposed to infection by their underlying disease, the incidence of severe post-operative infection was approximately 25%. No relation to age at time of splenectomy was evident. Ten of the 12 infections occurred within 12 years of operation. No attempt has been made to assess how great an increase, if any, this represents over a non-splenectomized control population similarly predisposed to infection. Our Experience, in addition to that of others, in the group predisposed to infection by their underlying disease, makes a total splenectomy population of 85; 23 (27%) of this group suffered severe post-operative infections.

Sign in / Sign up

Export Citation Format

Share Document