1/823. splenic rupture as a complication of P. falciparum malaria after residence in the tropics. Report of two cases. splenic rupture is an uncommon complication of malaria, which requires urgent medical investigation, close follow-up and adequate treatment. Until present, this complication was reported more often in P. vivax infections than in infections with other species. Rupture can happen spontaneously or as a result of trauma, which may be minor and unnoticed. The diagnosis is made by physical examination, ultrasound and CT-scan. Especially in malaria endemic areas the management of splenic rupture in malaria should be focused on splenic preservation. We describe two cases of splenic rupture during a P. falciparum infection, both requiring finally splenectomy. ( info) |
2/823. Post-traumatic thrombosis of a segmental branch of the inferior mesenteric vein. We report the case of man with post-traumatic thrombosis in a segmental branch of the inferior mesenteric vein with secondary venous congestion and ischemia of the sigmoid colon. We discuss the current imaging modalities for diagnosing venous thrombosis and their relative significance. ( info) |
| In her eighth month of pregnancy a woman was stabbed in the abdomen with a barbecue fork. Upon delivery one week later, the child was noted to have two scars in the thoracic region on the back. The legs were flaccid. Surgical exploration at the age of seven months revealed marked, dense scarring of spinal cord and arachnoid membrane. No similar case was found in the literature. ( info) |
4/823. Duodenal perforation following blunt abdominal trauma: case report. A case of severe duodenal injury in a 20-year-old female due to blunt abdominal trauma secondary to road traffic accident is presented. The difficulty and hence delay in making a diagnosis of duodenal injury is discussed. ( info) |
5/823. Surgical resection of traumatic spleen cysts by laparoscopy. Surgical resection of traumatic cysts by means of laparoscopy in two female patients is reported. The patients had sustained severe trauma in the left upper quadrant, were symptomatic and developed large splenic cysts found by computerized tomography, with an average diameter of 8.5 cm. Both patients were submitted to puncture and capsule removal by means of videolaparoscopy and diathermy; splenic parenchyma was preserved and the cyst's bed drained. No intra or postoperative complications occurred. After an average 21 months postoperative follow-up, both patients are symptom-free and no late recurrences were found on tomographic studies. The advantages of this technique over others that have been reported are the preservation of splenic parenchyma, its easy performance and efficient relief of symptoms, as well as being minimally invasive, associated with minimal postoperative pain, shorter length of hospital stay, and no early recurrences. ( info) |
6/823. Complete pyelo-calyceal avulsion as a result of blunt abdominal trauma. We present a rare case of complete avulsion of the kidney collecting system as a result of blunt abdominal trauma. Emergency celiotomy precluded radiographic studies. Perinephric hematoma was mild, the lesion was not detected and this later led to a nephrectomy. pelvis disruption diagnosis is frequently delayed, and this compromises surgical reconstruction. ( info) |
7/823. Reconstruction of disruption of the abdominal wall in burn patients. Two patients with extensive destruction of the full thickness of the abdominal wall and associated intra-abdominal injuries were encountered. One case resulted from burns to a patient pinned under an automobile in contact with the muffler; the other was injured as a result of penetration of the abdominal wall by a railroad coupling and was also burned in an associated welding accident at the same time. Extensive staged debridement and repair of intra-abdominal injuries in several procedures were required in case 1. Closure was eventually achieved with serial applications of mesh and split-thickness autografting. In case 2, an initial attempt at flap closure failed. Coverage initially was obtained with silicone mesh followed by split-thickness grafting. We report successful management of two of these difficult reconstructive challenges. ( info) |
8/823. splenosis presenting as an ulcerated gastric mass: endoscopic and endoscopic ultrasonographic imaging. A case of an ulcerated gastric wall mass ultimately found to be splenosis is presented in which the index patient had endoscopic and endoscopic ultrasonographic evaluation prior to resection. Although no visual features identified this mass as a splenic implant preoperatively, the lesion appeared to be atypical for leiomyoma, which led to surgical intervention. The role of endoscopic ultrasonography in assessing isolated gastric masses is discussed. ( info) |
9/823. Laparoscopic drainage of an intramural duodenal hematoma. A 21-year-old man was admitted with vomiting and abdominal pain 3 days after sustaining blunt abdominal trauma by being tackled in a game of American football. A diagnosis of intramural hematoma of the duodenum was made using computed tomography and upper gastrointestinal tract contrast radiography. The hematoma caused obstructive jaundice by compressing the common bile duct. The contents of the hematoma were laparoscopically drained. A small perforation was then found in the duodenal wall. The patient underwent laparotomy and repair of the injury. Laparoscopic surgery can be used as definitive therapy in this type of abdominal trauma. ( info) |
10/823. The abdominal compartment syndrome: a report of 3 cases including instance of endocrine induction. Three patients with the abdominal compartment syndrome are presented and discussed. In one of the patients the condition was induced in an endocrine fashion, since trauma was sustained exclusively by the middle third of the left leg. The development of the syndrome as a remote effect of local trauma has never been reported previously. In all three instances only insignificant amounts of intraperitoneal fluid was found and the increase in abdominal pressure was due to severe edema of the mesentery and retroperitoneum. Since the condition is highly lethal, early diagnosis is imperative, and this starts by carrying a high index of suspicion. Measurement of the intraperitoneal pressure easily confirms this diagnosis. It is emphasized that measurements at various sites, like bladder and stomach, in each patient is essential to confirm the diagnosis, since one of the sites may be rendered unreliable due to intraperitoneal processes impinging on the affected site and affecting its distensibility. ( info) |