Study on variations in hilar and segmental branching pattern of splenic artery

Background: Introduction of laparoscopic surgical methods requires exact knowledge of the topography of the spleen and its surrounding. Further advances in splenic conservative surgery are dependent on better knowledge of vascular anatomy of the spleen. Hence segmental arteries of spleen are of great surgical importance and their early identification in splenic trauma will lead to enhanced splenic conservation. Materials and methods: Present study carried out on 50 human spleen by dissection, silicon injection and radiological methods. We found different types of variations in hilar and segmental branching pattern of splenic artery. Observations and Results: in present study splenic artery divided in two primary branches in 86% and in three primary branches in14% of the spleens. superior polar branches were found in 44% while inferior polar branches were in 52% of the spleens. Two segmental branches found in 24%, three segmental found in 50%, four segmental in 18% and five segmental in 8% of the specimens. Intersegmental anastomosis found in 2% of spleens. Discussion: These segmental resection of spleen and further advances in splenic conservation are dependant on better understanding of vascular anatomy of the spleen.

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A pilot randomized controlled trial of endovascular coils and vascular plugs for proximal splenic artery embolization in high-grade splenic trauma

Abdominal Radiology ◽

10.1007/s00261-020-02904-w ◽

2021 ◽

Author(s):

Andrew J. Gunn ◽

Joel R. Raborn ◽

Russell Griffin ◽

Shannon W. Stephens ◽

Joshua Richman ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Splenic Artery ◽

Controlled Trial ◽

Splenic Trauma ◽

High Grade ◽

Artery Embolization ◽

Splenic Artery Embolization ◽

Randomized Controlled ◽

Endovascular Coils ◽

Pilot Randomized Controlled Trial

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Splenic Artery Embolization for Patients with High-Grade Splenic Trauma: Indications, Techniques, and Clinical Outcomes

Seminars in Interventional Radiology ◽

10.1055/s-0041-1724010 ◽

2021 ◽

Vol 38 (01) ◽

pp. 105-112

Author(s):

Majd Habash ◽

Darrel Ceballos ◽

Andrew J. Gunn

Keyword(s):

Clinical Outcomes ◽

Splenic Artery ◽

Splenic Injury ◽

Nonoperative Management ◽

Operative Management ◽

Splenic Trauma ◽

Trauma Patients ◽

High Grade ◽

Artery Embolization ◽

Splenic Artery Embolization

AbstractThe spleen is the most commonly injured organ in blunt abdominal trauma. Patients who are hemodynamically unstable due to splenic trauma undergo definitive operative management. Interventional radiology plays an important role in the multidisciplinary management of the hemodynamically stable trauma patient with splenic injury. Hemodynamically stable patients selected for nonoperative management have improved clinical outcomes when splenic artery embolization is utilized. The purpose of this article is to review the indications, technical aspects, and clinical outcomes of splenic artery embolization for patients with high-grade splenic injuries.

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Conservative Surgical Management for Pulmonary Hydatid Cyst: Analysis and Outcome of 148 Cases

Canadian Respiratory Journal ◽

10.1155/2016/8473070 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Mohammed Aldahmashi ◽

Mohamed Alassal ◽

Ibrahim Kasb ◽

Hany Elrakhawy

Keyword(s):

Hydatid Cyst ◽

Bronchopleural Fistula ◽

Complete Removal ◽

Conservative Surgery ◽

Hydatid Cysts ◽

Rural Regions ◽

Purse String ◽

Lung Cysts ◽

Surgical Methods ◽

Pulmonary Hydatid Cyst

Background. Hydatid cyst (HC) disease is endemic in many developing countries, like Yemen, Egypt, and Saudi Arabia, especially in the rural regions. The disease has a variable clinical courses and even might be asymptomatic for many years.Objectives. In giant and large pulmonary hydatid cysts, pulmonary resection is the usual method of surgical treatment. In this study, we aimed to evaluate the lung conservative surgery in treatment of cases with giant and large hydatid lung cysts, as an effective method of management.Patients and Methods. Between January 2009 and August 2014, a total of 148 patients with pulmonary hydatid cysts were operated and their data was reviewed retrospectively and analyzed. Out of these cases, 52 (35.14%) cysts with more than 10 cm in diameter and 36 (24.32%) cysts with 5–9 cm were regarded as giant and large hydatid lung cysts, respectively. The small cysts less than 5 cm were presented in 8 (5.4%) cases only; other cases had ruptured cysts. Preservation of the lung tissues during surgery by cystotomy and Capitonnage was our conservative surgical methods of choice.Results. Eight patients developed bronchopleural fistula (BPF); of them, 4 BPFs have healed with chest tube and physiotherapy, but in the other 4 patients reoperation was done for the closure of persistent BPF. No mortality was observed in the present study.Conclusion. We conclude that conservative surgical procedure can achieve complete removal of the pulmonary hydatid cyst. Enucleation of the intact huge cysts is safe. Careful and secured closure of the bronchial communication should be done by purse string or figure-of-8 sutures, with or without Teflon pledgets. These simple procedures are safe, reliable, and successful.

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COVERAGE OF EXPOSED TIBIA

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.01.1977 ◽

2010 ◽

Vol 17 (01) ◽

pp. 44-49

Author(s):

TAJAMMAL ABBAS SHAH ◽

USMAN LATIF ◽

QUDDUS-UR- REHMAN

Keyword(s):

Wound Infection ◽

Lower Limb ◽

Road Traffic ◽

Musculocutaneous Flaps ◽

Degloving Injury ◽

Limb Injuries ◽

Surgical Methods ◽

Different Types ◽

Bone Coverage ◽

Comparative Prospective Study

The alarming rise in road traffic accident has resulted in increased incidence of degloving lower limb injuries requiring some sortof cover for exposed bones e.g tibia. Objective: To study and compare the rate of wound infection & decreased morbidity in degloving injuriesof lower limb following early bone coverage by various surgical methods of bone coverage. Design: Comparative, prospective study, Place& duration of study. Allied Hospital SU II Faisalabad. Period: From January 2002 to October 2004. Material & Methods: Thirty (30) patientsdivided into four groups, muscle & musculocutaneous flaps for 15 patients, local rotational flaps for 05 patients, cross leg flaps & decorticationfor 05 patients. The patients in each group were divided unequally because of unavailability of patients. Patients were also examinedpostoperatively for 06 weeks. Results: The patients underwent surgery for degloving injury of leg. Most of them were young malesbetween 5-45 years of age resulting mainly from different types of accidents. 2 out of 15(13.3%) patients having, musculocutaneous flapsdeveloped wound infection. 1 out of 5(20%) with local rotational flaps, 2 out of 5 (40%) with cross leg flaps & 3 out of 5(60%) with decorticationdeveloped wound infection. 14 out of 15(93.3%) patients with muscle & musculocutaneous flaps while 4 out of 5(80%) with local rotational flapsrecovered within 3 weeks. Patients with cross leg flaps recovered after one month while patients with decortication recovered after forty fivedays. 13 out of 15 regained full function (86%) with muscle & musculocutaneous flaps while patients having local rotational flaps regained 100%full function. 4 out of 5(80%) regained full function with cross leg flaps & 1 out of 5(20%) regained full function with decortication. Conclusions:Muscle & musculocutaneous flaps for exposed tibia is safe and effective method of treatment having low rate of wound infection with widercoverage & decreased morbidity.

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CAVERNOUS HAEMANGIOMA IN THE GASTROCNEMIUS MUSCLE: A RARE PRESENTATION IN THE GERIATRIC AGE GROUP

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703812 ◽

2014 ◽

Vol 04 (03) ◽

pp. 101-104 ◽

Cited By ~ 1

Author(s):

H. Ravindranath Rai ◽

Arjun Ballal ◽

Keerti Mohan ◽

Rajsankar N. R.

Keyword(s):

Correct Diagnosis ◽

Left Knee ◽

Cavernous Haemangioma ◽

Rare Presentation ◽

Posterior Aspect ◽

Adequate Treatment ◽

Capillary Haemangioma ◽

Surgical Methods ◽

Distinctive Type ◽

Radiological Methods

AbstractIntramuscular haemangiomas are believed to be hamartomatous and are a distinctive type of haemangioma occurring within skeletal muscle. They account for less than 1% of all haemangiomas. They occur more often in trunk and extremity muscles.A sixty five year old lady presented with swelling and pain from the back of the left knee for two years.On clinical examination, a mass of about 10X10 cms in size was noted in the left popliteal fossa. The swelling was tender with well defined borders but fixed to the muscle. She had a flexion deformity of knee of ten degrees.MRI revealed a large encapsulated cystic lesion in the posterior aspect of the muscular compartment of the knee.She underwent excision of the mass, intraoperatively the mass was noted to be arising from the gastrocnemius. Histopathology revealed large cavernous filled spaces filled with blood which indicated a cavernous haemangioma.Most of the literature suggest the occurance of capillary haemangioma to be a commoner one. Occurance of a cavernous haemangioma is usually before the third decade and is congenital in most times. Most of the authors emphasize that radiological methods are generally insufficient for the correct diagnosis of intramuscular hemangiomas, and surgery is the treatment of choice to exclude malignancy and for adequate treatment of these lesions.Hence, the present case which we are reporting here is a rare occurance of a cavernous haemangioma of the gastrocnemius in a 65 year old lady, which was managed by surgical methods.

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Morphometric analysis of the splenic artery using contrast-enhanced computed tomography (CT)

Surgical and Radiologic Anatomy ◽

10.1007/s00276-020-02598-1 ◽

2020 ◽

Author(s):

David J. Brinkman ◽

Stephanie Troquay ◽

Wouter J. de Jonge ◽

Eric D. Irwin ◽

Margriet J. Vervoordeldonk ◽

...

Keyword(s):

Immune Modulation ◽

Splenic Artery ◽

Experimental Studies ◽

Pancreatic Tissue ◽

Branching Pattern ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

And Gender ◽

Enhanced Computed Tomography

Abstract Purpose To evaluate the morphology and course of the splenic artery, which might impact the surgical implantation of systems that stimulate the nerves surrounding the splenic artery. Experimental studies indicate that these nerves play an important part in immune modulation, and might be a potential target in the treatment of autoimmune diseases. Methods This retrospective cohort study made use of contrast-enhanced CT images from 40 male and 40 female patients (age 30–69) that underwent a CT examination of the aorta, kidneys or pancreas. Anatomic features were described including total splenic artery length, calibers, tortuosity, the presence of arterial loops and the branching pattern of the splenic artery. Results No age-gender-related differences could be found related to tortuosity or branching pattern. The length of splenic artery in contact with pancreatic tissue decreased with increasing age, but was not different between genders. Artery diameters were wider in male compared to female subjects. Loops of variable directions, that represent a part of the artery that curls out of the pancreatic tissue, were identified in each age-gender category and were present in nearly all subjects (86%). Conclusion This study suggests that although some anatomic features of the splenic artery are subject to factors as age and gender, the tortuosity of the splenic artery is not age dependent. Most subjects had one or multiple loops, which can serve as a target for neuromodulatory devices. Future studies should investigate whether splenic nerve stimulation is safe and feasible.

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