3 research outputs found
Π‘ΠΏΠ»Π΅Π½ΠΎΠ·: ΠΏΡΡΡ Π½Π΅ΠΈΠ·Π²Π΅ΡΡΠ½ΠΎΡΡΠΈ ΠΈΠ»ΠΈ ΡΠ°Π³ ΡΠ΅ΡΠ΅Π· ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΠ΅ ΠΏΡΠ΅Π΄ΠΎΡΡΠΎΡΠΎΠΆΠ½ΠΎΡΡΠΈ (ΡΠ°ΡΡΡ I)
Aim: to present a rare clinical case of multiple post-traumatic intra-abdominal splenosis in combination with type 2 macroamylasemia, chronic pancreatitis in a 27-year-old woman, clinically manifested like a palpable mass in the right iliac region.Main results. In the first part of the article, a detailed analysis of the medical history is given, the results of archival imaging studies and the data of laboratory and instrumental examination at the time of treatment are presented. The literature review presents modern definitions of splenosis, as well as brief information about the anatomy and physiology of the spleen.Conclusion. The diagnostic process requires a detailed analysis of the history of the disease, the performance of laboratory studies in combination with modern imaging studies, as well as a thorough study of the literature data.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΡ ΡΠ΅Π΄ΠΊΠΈΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΡΡΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠ½ΡΡΠ°Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΏΠ»Π΅Π½ΠΎΠ·Π° Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΠΌΠ°ΠΊΡΠΎΠ°ΠΌΠΈΠ»Π°Π·Π΅ΠΌΠΈΠ΅ΠΉ 2-Π³ΠΎ ΡΠΈΠΏΠ°, Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠΎΠΌ Ρ ΠΆΠ΅Π½ΡΠΈΠ½Ρ 27 Π»Π΅Ρ, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ ΠΌΠ°Π½ΠΈΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π²ΡΠ΅Π³ΠΎ ΠΏΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°Π»ΡΠΏΠΈΡΡΠ΅ΠΌΠΎΠ³ΠΎ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ Π² ΠΏΡΠ°Π²ΠΎΠΉ ΠΏΠΎΠ΄Π²Π·Π΄ΠΎΡΠ½ΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ.ΠΡΠ½ΠΎΠ²Π½ΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ. Π I-ΠΉ ΡΠ°ΡΡΠΈ ΡΡΠ°ΡΡΠΈ ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½ Π΄Π΅ΡΠ°Π»ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π°Π½Π°ΠΌΠ½Π΅Π·Π° Π±ΠΎΠ»Π΅Π·Π½ΠΈ, ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π°ΡΡ
ΠΈΠ²Π½ΡΡ
Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·ΠΈΡΡΡΡΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΈ Π΄Π°Π½Π½ΡΠ΅ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΠΎ-ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ. Π ΠΎΠ±Π·ΠΎΡΠ΅ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΈΠ·Π»ΠΎΠΆΠ΅Π½Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΏΠΎΠ½ΡΡΠΈΡ ΡΠΏΠ»Π΅Π½ΠΎΠ·, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΊΡΠ°ΡΠΊΠΈΠ΅ ΡΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΎΠ± Π°Π½Π°ΡΠΎΠΌΠΈΠΈ ΠΈ ΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠ΅Π»Π΅Π·Π΅Π½ΠΊΠΈ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΡΠΎΡΠ΅ΡΡ ΡΡΠ΅Π±ΡΠ΅Ρ Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° Π°Π½Π°ΠΌΠ½Π΅Π·Π° Π±ΠΎΠ»Π΅Π·Π½ΠΈ, Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ΠΌ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·ΠΈΡΡΡΡΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ½ΡΡ
Π΄Π°Π½Π½ΡΡ
Abernethy Malformation in Combination with Gilbertβs Syndrome
Aim. To present a clinical case of the Abernethy syndrome.Key points. Abernethy syndrome is a rare vascular anomaly associated with a congenital absence of the portal vein, as a result of which portal blood from the intestines and spleen drains directly into the systemic circulation bypassing the liver though a complete or partial shunt. In the vast majority of cases, Abernethy syndrome is manifested during the newborn period by jaundice syndrome, hypergalactosemia and encephalopathy. In rare cases, this vascular malformation is diagnosed in older patients during ultrasound screening. A 31 year-old patient sought medical attention with the complaints of sleep disturbance and fatigue. The conducted instrumental observation revealed echo-signs of malformation (agenesia) of the portal vein, which was further confirmed by both X-ray-contrast computed tomography and the pathohistological analysis of liver biopsy slides. The genotype UGT1A1β’28 confirmed Gilbert's syndrome. Neutropenia (0.8 Γ 109/L) with a drop in the level of segmented neutrophils up to 27% was regarded as shunt neutropenia. Number connection test confirmed shunt encephalopathy. Conservative therapy for correcting hepatic encephalopathy was prescribed, followed by a dynamic monitoring of the patientβs condition.Conclusion. Diagnosis of Abernethy malformation is important for choosing the right treatment for the timely correction of complications of the disease and early detection of adenoma or hepatocellular carcinoma
Π‘ΠΏΠ»Π΅Π½ΠΎΠ·: ΠΏΡΡΡ Π½Π΅ΠΈΠ·Π²Π΅ΡΡΠ½ΠΎΡΡΠΈ ΠΈΠ»ΠΈ ΡΠ°Π³ ΡΠ΅ΡΠ΅Π· ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΠ΅ ΠΏΡΠ΅Π΄ΠΎΡΡΠΎΡΠΎΠΆΠ½ΠΎΡΡΠΈ (ΡΠ°ΡΡΡ II)
Aim: to present a review of the literature on post-traumatic splenosis of different localization, as well as to complete the presentation of a rare clinical case of multiple post-traumatic intra-abdominal splenosis in combination with type 2 macroamylasemia, chronic pancreatitis in a 27-year-old woman.Main results. The literature data of the pathogenesis and classification of splenosis are considered. Close attention is paid to the clinical manifestations of post-traumatic splenosis: the results of imaging studies in intrathoracic, disseminated abdominal, intrahepatic and intrapancreatic forms of splenosis are presented.The end of the description of a rare clinical case of progressive multiple post-traumatic intra-abdominal splenosis in combination with type 2 macroamylasemia and chronic pancreatitis is presented. The process of diagnostic search, differential diagnosis is described, the controversial points to the patientβs management, the possibility and expediency of pregnancy are considered.Conclusion. The exclusivity of this clinical case requires further dynamic monitoring, especially in the possible pregnancy.Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΎΠ±Π·ΠΎΡΠ° Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ, ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π½ΠΎΠΉ ΠΏΠΎΡΡΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΌΡ ΡΠΏΠ»Π΅Π½ΠΎΠ·Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ Π·Π°Π²Π΅ΡΡΠΈΡΡ ΠΈΠ·Π»ΠΎΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅Π΄ΠΊΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΠ°Ρ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΡΡΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠ½ΡΡΠ°Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΏΠ»Π΅Π½ΠΎΠ·Π° Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΠΌΠ°ΠΊΡΠΎΠ°ΠΌΠΈΠ»Π°Π·Π΅ΠΌΠΈΠ΅ΠΉ 2-Π³ΠΎ ΡΠΈΠΏΠ°, Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠΎΠΌ Ρ ΠΆΠ΅Π½ΡΠΈΠ½Ρ 27 Π»Π΅Ρ.ΠΡΠ½ΠΎΠ²Π½ΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ. Π Π°ΡΡΠΌΠΎΡΡΠ΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ, ΠΎΡΠ²Π΅ΡΠ°ΡΡΠΈΠ΅ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π· ΠΈ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ ΡΠΏΠ»Π΅Π½ΠΎΠ·Π°. ΠΡΠΈΡΡΠ°Π»ΡΠ½ΠΎΠ΅ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ ΡΠ΄Π΅Π»Π΅Π½ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡΠΌ ΠΏΠΎΡΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΏΠ»Π΅Π½ΠΎΠ·Π°: ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·ΠΈΡΡΡΡΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΡΠΈ Π²Π½ΡΡΡΠΈΠ³ΡΡΠ΄Π½ΠΎΠΉ, Π΄ΠΈΡΡΠ΅ΠΌΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΠΎΠΉ, Π²Π½ΡΡΡΠΈΠΏΠ΅ΡΠ΅Π½ΠΎΡΠ½ΠΎΠΉ ΠΈ Π²Π½ΡΡΡΠΈΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΌΠ°Ρ
ΡΠΏΠ»Π΅Π½ΠΎΠ·Π°.ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ ΠΎΠΊΠΎΠ½ΡΠ°Π½ΠΈΠ΅ ΠΎΠΏΠΈΡΠ°Π½ΠΈΡ ΡΠ΅Π΄ΠΊΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΠ°Ρ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΡΡΡΠ΅Π³ΠΎ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΡΡΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠ½ΡΡΠ°Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΏΠ»Π΅Π½ΠΎΠ·Π° Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΠΌΠ°ΠΊΡΠΎΠ°ΠΌΠΈΠ»Π°Π·Π΅ΠΌΠΈΠ΅ΠΉ 2-Π³ΠΎ ΡΠΈΠΏΠ°, Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠΎΠΌ. ΠΠΏΠΈΡΠ°Π½ ΠΏΡΠΎΡΠ΅ΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠΈΡΠΊΠ°, Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, ΡΠ°ΡΡΠΌΠΎΡΡΠ΅Π½Ρ Π΄ΠΈΡΠΊΡΡΠ°Π±Π΅Π»ΡΠ½ΡΠ΅ ΠΌΠΎΠΌΠ΅Π½ΡΡ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ, Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΈ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎΡΡΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΊΠ»ΡΡΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΠ°Ρ ΡΡΠ΅Π±ΡΠ΅Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅Π³ΠΎ Π΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ Π² ΡΠ»ΡΡΠ°Π΅ Π½Π°ΡΡΡΠΏΠ»Π΅Π½ΠΈΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ.