1/21. Epithelial splenic cysts in an intrapancreatic accessory spleen and spleen.A rare case of cysts simultaneously occurring in the intrapancreatic accessory spleen and spleen in a 49-year-old female is reported. The patient underwent distal pancreatomy for a cystic tumor of the pancreas, and a splenectomy. A multilocular cyst (4.3 x 2.6 cm) in an accessory spleen at the pancreas tail, and a solitary cyst (1.2 x 0.9 cm) of the spleen were found. The cyst in the intrapancreatic accessory spleen was lined by non-keratinizing stratified squamous epithelium, and the spleen cyst by a single layer of flat epithelium; these lining cells were positive for alcian blue stain and periodic acid-schiff reaction, and were immunohistochemically positive for cytokeratin, HBME-1 and Sialyl-Tn. Epithelial membrane antigen, carcinoembryonic antigen and CA19-9 were positive in the accessory spleen cyst but were negative in the spleen cyst. An electron microscopic examination of the flat epithelium of the spleen cyst revealed numerous microvilli on the surface, cytoplasmic microfilaments, and a number of tight junctions between adjacent cells. These features suggested that the two cysts differ in nature, and origin; the accessory spleen cyst may be an embryonic inclusion of the pancreas duct while the spleen cyst may be an inclusion cyst of the mesothelium.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/21. Power Doppler sonographic diagnosis of torsion in a wandering spleen.A wandering spleen is a rare clinical entity resulting from congenital maldevelopment or acquired laxity of the spleen's suspensory ligaments; it may result in torsion of the spleen. We report the gray-scale sonographic, power Doppler sonographic, and CT findings in a case of wandering spleen torsion. The gray-scale sonograms showed a displaced spleen that appeared as a homogeneous, hypoechoic mass suggestive of an enlarged, ectopic spleen in the central abdomen. Power Doppler sonograms showed no blood flow in the parenchyma or hilum of the spleen and were consistent with torsion and infarction in the spleen. Contrast-enhanced CT scans showed a homogeneous, unenhanced mass that was diagnosed as a torsioned wandering spleen. The hilar vessels of the spleen were also unenhanced.- - - - - - - - - - ranking = 94.041906973567keywords = ligament (Clic here for more details about this article) |
3/21. Laparoscopic splenopexy by peritoneal and omental pouch construction for intermittent splenic torsion ("wandering spleen").wandering spleen is an extremely rare anatomic variant with potentially serious clinical implications. Usually, splenectomy is advocated for treatment of this disease. Various methods for preserving the wandering spleen by means of splenopexy have been described, including two reports on laparoscopic splenic refixation. We describe the third case in which laparoscopic splenopexy was used to manage chronic intermittent splenic torsion. In a 25-year-old woman, splenopexy was successfully performed by laparoscopic reposition and fixation of the spleen by omental pouch creation. At laparoscopy with a normal operating room setup and four trocars, a free-floating, macroscopically normal spleen attached to an abnormally long vascular pedicle with no gastrosplenic or phrenicosplenic ligaments was detected in the lower right quadrant. The spleen was repositioned and placed in the left phrenorenal angle. Splenopexy was achieved by suturing the left colophrenic ligament to the lateral diaphragm, thus creating a pouch for the inferior part of the spleen, and by suturing the gastrocolic ligament to the anterior diaphragm to create a pouch for the upper splenic pole. The postoperative course was uneventful. At a follow-up examination 3 months after the operation, the patient was well, with no further episode of recurrent abdominal pain. Ultrasonographically, the spleen was seen easily in the left hypochondrium in its normal physiologic position. Laparoscopic splenopexy is a useful option for organ-preserving therapy of the wandering spleen.- - - - - - - - - - ranking = 282.1257209207keywords = ligament (Clic here for more details about this article) |
4/21. Gastric volvulus associated with congenital diaphragmatic hernia, wandering spleen, and intrathoracic left kidney: CT findings.We present an unusual case of gastric volvulus associated with wandering spleen, a delayed manifestation of congenital diaphragmatic hernia and left intrathoracic kidney. Gastric volvulus should be considered in any infant with unexplained vomiting and left diaphragmatic anomaly: in these patients, developmental disorders of the peritoneal visceral attachments of the left upper abdomen may coexist. The absence of ligamentous connections between the stomach, posterior abdominal wall, and spleen result in wandering spleen. We emphasize prompt surgical therapy to avoid gastric and splenic necrosis. Radiologic findings and the appearance of this complex congenital malformation are reported.- - - - - - - - - - ranking = 94.041906973567keywords = ligament (Clic here for more details about this article) |
5/21. Splenic actinomycotic abscess in a patient with acute myeloid leukemia.actinomycosis is a gram-positive anaerobic bacterium. actinomyces organisms are important constituents of the normal flora of mucous membranes and are considered opportunistic pathogens. The three major clinical presentations of actinomycosis include the cervicofacial, thoracic, and abdominopelvic regions. actinomycosis infection in patients with febrile neutropenia is uncommon and actinomycosis splenic involvement in acute leukemia patients is very rare. We describe a man with acute myeloid leukemia and splenic actinomycotic abscess that developed after chemotherapy following prolonged neutropenia.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
6/21. wandering spleen as an asymptomatic pelvic mass.BACKGROUND: wandering spleen is caused by laxity of the ligaments surrounding the spleen and may present as an asymptomatic pelvic mass. CASE: A 20-year-old woman with a neurogenic bladder was diagnosed with a pelvic mass on a routine screening ultrasound. The mass was described as solid and multilobulated, with the lobules measuring up to 5 cm in diameter. She was completely asymptomatic. Exploratory laparotomy revealed a wandering spleen. CONCLUSION: wandering spleen, though unusual, should be included on the differential diagnosis of patients with an asymptomatic solid pelvic mass.- - - - - - - - - - ranking = 94.041906973567keywords = ligament (Clic here for more details about this article) |
7/21. Mass at the splenic hilum: a clue to torsion of a wandering spleen located in a normal left upper quadrant position.wandering spleen is an extremely rare condition in which the spleen is lacking its normal ligamentous attachments and therefore can move to an ectopic position in the abdomen or pelvis. wandering spleen predisposes the patient to life-threatening complications due to torsion of the spleen's vascular pedicle, with resulting splenic infarction, portal hypertension, and bleeding. Because of the nonspecific symptoms, imaging plays an important role. To our knowledge, only a few case reports describing wandering spleen in the pediatric population have been published, including 2 cases in infancy. We report a case of splenic torsion in an infant with a preoperative diagnosis made on the basis of color and power Doppler sonography. The diagnosis was confirmed by contrast-enhanced helical computed tomography (CT) and proved at surgery. On sonography, a diffusely hypoechoic spleen and a mass at the splenic hilum representing the torsed splenic pedicle were shown. The splenic hilar mass correlates with the CT "whirl" sign indicative of torsion.- - - - - - - - - - ranking = 94.041906973567keywords = ligament (Clic here for more details about this article) |
8/21. Torsion of a wandering spleen: acute abdominal presentation.Torsion of a wandering spleen is a rare but fulminant condition and is part of the differential diagnosis in patients presenting with acute abdominal pain. It results due to absence or laxity of the various ligaments supporting the spleen. patients may be asymptomatic or may present with acute abdominal pain. It may occur in people of all ages, with a predilection for male patients under 10 years of age and for female patients in older age groups, being most common in multiparous women. Early intervention is necessary to reduce the risk of splenic infarction and other complications. An awareness of the condition together with use of appropriate medical imaging can lead to the correct diagnosis.- - - - - - - - - - ranking = 94.041906973567keywords = ligament (Clic here for more details about this article) |
9/21. Unusual manifestations of yersinia enterocolitica infections diagnosed using novel methods.We report the cases of two patients who had infections due to yersinia enterocolitica. The first patient exhibited chronic recurrent fever, hepatic and splenic granulomas, and bone marrow abnormalities, and the second patient presented with enterocolitis with leukocytoclastic vasculitis of the skin. Cultures and agglutination titers were negative. Indirect immunofluorescence techniques with use of serotype-specific antisera and antisera to Yersinia outer-membrane proteins (Yops) were applied to biopsy specimens, and immunoblotting techniques for determining class-specific circulating antibodies to Yops were used for demonstrating these unusual manifestations of Y. enterocolitica infections.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
10/21. wandering spleen with torsion of vascular pedicle: early diagnosis with multiplaner reformation technique of multislice spiral CT.wandering spleen is a rare clinical radiologic entity characterized by splenic hypermobility due to laxity or maldevelopment of the supporting splenic ligaments. The cause for hypermobility may be hormonal changes during pregnancy or failure of fusion of the dorsal peritoneum. patients may be asymptomatic, present with a movable lump in the abdomen, or present with acute, chronic, or intermittent symptoms due to torsion of the wandering spleen. Early clinical diagnosis is difficult, so imaging modalities play an important role. We report a case of wandering spleen in which multiplanar reformation of thin maximum intensity projection images played a pivotal role in its precise diagnosis.- - - - - - - - - - ranking = 94.041906973567keywords = ligament (Clic here for more details about this article) |
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