Cases reported "Splenic Rupture"

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11/376. Splenic peliosis: a rare complication following liver transplantation.

    In this article, we report a rare case of isolated splenic peliosis in an individual who had recently undergone liver transplantation. The disorder had remained clinically and radiologically undiagnosed until he suffered a traumatic rupture of the affected organ. The relevant literature on this topic is briefly reviewed.
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keywords = rupture
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12/376. Ruptured primary splenic angiosarcoma into the colon. Presentation as anal bleeding.

    A 71-year-old woman presented with a six month history of constipation and abdominal discomfort, with anal bleeding during the last days. ultrasonography and CT-scan of the abdomen showed a large heterogeneous mass that was located in the splenic region, but the nature and origin of the tumour could not be clearly established preoperatively. The clinical diagnosis was of abdominal tumour with colonic and splenic involvement, and a left hemicolectomy and splenectomy were performed. Pathologic examination revealed a primary angiosarcoma of the spleen with penetration and fistulization of the tumour into the large bowel. The patient received adjuvant radiation therapy, but she died of extensive metastastic disease from her primary angiosarcoma of the spleen nine months after surgery. In summary, splenic angiosarcoma is very difficult to diagnose preoperatively. This highly aggressive neoplasm has an overall poor prognosis, specially if it is associated with rupture and haemoperitoneum. As this case highlights, unusual forms of rupture may lead to atypical clinical presentations, increasing even more the difficulty in the diagnosis.
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keywords = rupture
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13/376. Occult splenic rupture: a case report.

    We present a case of an atraumatic, occult rupture of the spleen. It is only in a distinct minority of cases, that the splenic capsule remains intact, thereby preventing intraperitoneal bleeding. Nevertheless, this condition can be accompanied by a severe loss of blood. A nonoperative management can be considered. Reviewing the literature on splenic rupture, the lack of uniformity in nomenclature is striking. The etiological and morphological classifications are reviewed.
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ranking = 6
keywords = rupture
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14/376. Delayed splenic rupture in a haemophiliac.

    We report an unusual case of post-traumatic delayed rupture of the spleen occurring in a 38-year-old man with haemophilia A. The time interval between injury and splenic rupture was at least 2 weeks. Although a rare event, the possibility of splenic rupture should always be considered in the differential diagnosis in patients with a bleeding disorder and abdominal pain, even when the patient does not initially give a history of abdominal injury. Radiological imaging, including ultrasound examination, is of great value in establishing the diagnosis. This case report includes a brief review of other similar cases.
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ranking = 7
keywords = rupture
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15/376. splenosis mimicking metastases from breast carcinoma.

    The case history is presented of a patient with breast cancer who was extensively investigated for presumed hepatic metastases, which were finally diagnosed as splenosis, the heterotopic autotransplantation of splenic tissue after traumatic rupture of the spleen. This case history highlights the importance of obtaining a pathological diagnosis prior to labelling a patient as having metastatic disease. This is especially important for patients who have an unusual pattern or appearance of metastases or for whom the risk of metastatic disease is presumed to be minimal.
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ranking = 1
keywords = rupture
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16/376. Report of a fatal case of dengue infection with hepatitis: demonstration of dengue antigens in hepatocytes and liver apoptosis.

    A fatal case of dengue (DEN) infection associated with a spleen rupture and with hepatitis is reported here. Microscopic studies showed numerous areas of spleen rupture with hematomas and revealed necrotic foci in liver samples obtained at autopsy. Although hepatitis was reported in several cases of DEN fever, the mechanism of liver injury remains poorly understood. In this case, immunohistochemistry showed that DEN viral antigens were mostly detected in hepatocytes surrounding the necrotic foci. By in situ detection of dna fragmentation, apoptotic hepatocytes were found to be colocated with DEN virus-infected hepatocytes. These findings suggest that hepatocytes are the major sites of DEN virus replication in the liver and that DEN virus induces apoptosis of hepatocytes in vivo.
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keywords = rupture
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17/376. Intra-abdominal bleeding caused by spontaneous rupture of an accessory spleen: the CT findings.

    Accessory spleens are common. Their clinical importance lies in the need to include their removal when performing a splenectomy for primary haematological disorders, or as the source of 'preservable' splenic tissue in cases of ruptured primary spleen. Rupture of a normal spleen almost always occurs because of trauma, spontaneous rupture is rare. In pathological spleens, however, 'spontaneous' rupture is more widely reported, although it is argued that minor trauma is often still responsible in these cases. We report a case of spontaneous isolated rupture of a histologically normal accessory spleen and show the CT findings.
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ranking = 8
keywords = rupture
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18/376. splenic rupture associated with severe preeclampsia. A case report.

    BACKGROUND: splenic rupture is a very rare event complicating pregnancy. Approximately 5% of cases reported have involved the postpartum period. Unrecognized, this complication is universally fatal. CASE: Preeclampsia and pulmonary edema complicated a 42-year-old woman's intrapartum care. After cesarean delivery she was supported with mechanical ventilation, blood products and invasive monitoring. Shortly thereafter, she became hypotensive and developed disseminated intravascular coagulation. During exploratory laparotomy a splenic capsular rupture was identified. splenectomy and continued intensive care support ultimately reversed the severe end-organ consequences. CONCLUSION: It is extremely important that this condition be maintained in the diagnostic differential of post-operative hemodynamic instability. Failure to identify it is invariably fatal. awareness and intervention are essential to ensure a good outcome.
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ranking = 6.0012497910019
keywords = rupture, capsular
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19/376. splenic rupture in children with hematologic malignancies.

    BACKGROUND: splenic rupture is an uncommon but life-threatening complication of leukemias and lymphomas, and is reported mostly in adults. The authors investigated the frequency with which splenic rupture is diagnosed in pediatric patients with hematologic malignancies and reviewed its clinical profile and outcome. methods: The data base of St. Jude Children's research Hospital was searched for cases coded as splenic laceration or rupture, splenic infarction, or splenectomy in patients diagnosed with lymphoma or leukemia between January 1962 and December 1997. The medical records of patients with histopathologic or radiologic evidence of splenic rupture were reviewed. The time spanned by the study was divided into early (1962-1990) and recent (1991-1997) eras to reflect the availability of modern diagnostic imaging techniques. RESULTS: Seven children experienced splenic rupture. They were between ages 5-17 years. There were four males and three females. Primary diagnoses included acute myeloid leukemia (four patients), acute lymphoblastic leukemia (two patients), and Hodgkin lymphoma (one patient). Five patients were diagnosed in the recent era and two in the early era. Four patients had radiologic or bacteriologic evidence of fungal infection concomitant with the splenic event. Of five deaths, only two were related causally to splenic rupture; these occurred in the early era. All seven acute episodes of splenic rupture were managed conservatively without surgery. CONCLUSIONS: The overall frequency with which splenic rupture was detected in children with hematologic malignancy at the study institution was 0.18%. In the recent era, the frequency of detection was 9-fold higher (0.55%) than that of the early era (0.06%). Improved imaging techniques and increased utilization of imaging studies may account for the increased incidental detection of "preclinical" splenic rupture. adolescent age group, acute myeloid leukemia (especially acute promyelocytic leukemia), a high leukocyte count, thrombocytopenia, and coagulopathy may predispose children with leukemia to pathologic splenic rupture. Fungal infection frequently was associated with splenic rupture and may play a role in its pathogenesis.
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ranking = 15
keywords = rupture
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20/376. Nonoperative management of newborn splenic injury: a case report.

    Traumatic injury of the spleen is rare in newborns. Nonoperative management of pediatric splenic injuries is now recognized as the treatment of choice, but there is scant experience with the problem in neonates. The authors report their experience with a neonatal splenic rupture, managed nonoperatively.
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ranking = 1
keywords = rupture
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