9 research outputs found
A planned delayed laparoscopy in a gunshot injury case with spleen and diaphragmatic damage
The basic treatment of thoracoabdominal gunshot injury is surgery. However, a conservative approach is increasingly becoming widespread in selected cases. In this study, the management of a patient with a spleen and diaphragm damage due to a gunshot injury who treated with delayed surgery was presented. A 37-year-old man was admitted with a gunshot injury and a computed tomography showed splenic and left diaphragmatic injury. His vital signs were stable and after a 3 days of conservative treatment, laparoscopic repair of the diaphragm was performed and the patient was discharged uneventfully. When a diaphragmatic injury is accompanied by splenic injury in the case of the patient is stable and there is no need for emergency surgery, the repair of the diaphragm may be delayed to prevent unnecessary splenectomy
A rare cause of ileus: Wandering spleen
Wandering spleen (WS) is a rare clinical condition resulting
from an abnormally long splenic pedicle and the absence
or weakening of the supporting splenic ligaments
that help to hold the spleen stationary. WS is more commonly
seen in females aged between 20 and 40 years.
Congenital and acquired factors are reported as the
predisposing factors for WS. Patients with WS may be
asymptomatic, or may be evident with a painful abdominal
mass or an acute abdomen due to gastrointestinal
symptoms and torsion of the WS. The diagnosis of WS
can be established incidentally or during the Ultrasonography
(USG) or Computed Tomography (CT) explorations
performed for other pathologies. A high index of suspicion
aids in the diagnosis of WS. WS is mostly treated by
surgery and splenopexy remains the method of choice.
In the cases with persistent ischemia following detorsion,
splenectomy should be performed either via laparoscopy
or laparotomy. In the present report, we present
a 37-year-old woman who presented with a wandering
spleen causing ileus. The patient underwent laparoscopic
splenectomy. Wandering spleen is a rare condition which
should be suspected as a potential cause of ileus and
acute abdomen
Our clinical experience on laparoscopic splenectomy: Outcomes of 38 patients
Objective: Laparoscopic splenectomy has gained widespread acceptance in the treatment of hematological diseases in recent years. In this study, we aimed to present the outcomes of the patients who underwent laparoscopic splenectomy.
Methods: Between 2012 and 2015, the data of 38 patients, who underwent laparoscopic splenectomy for hematological diseases at our clinic, were evaluated retrospectively.
Results: 15 males and 23 females patients were underwent laparoscopic splenectomy, and the average age was 33.9 ± 12.9 years. Indications for splenectomy were idiopathic thrombocytopenic purpura (ITP) in 34 patients, and hereditary spherocytosis in 4 patients. During the surgical exploration, accessory spleen was detected in 7 patients, and removed. Laparoscopic cholecystectomy was performed at the same session in 2 hereditary spherocytosis patients who had stones in the gallbladder. One patient was converted to the open surgery due to the bleeding which was eliminated the exposure during the dissection. At the postoperative period, we observed atelectasis in one patient, and wound fat necrosis in one patient. In addition, thrombocytosis was observed in one patient. Hematological treatment was continued because of persistent refractory thrombocytopenia in two patients, and temporary thrombocytopenia in four patients. An accessory spleen was detected with splenic scintigraphy in one of these patients at the postoperative period. The average hospitalization time was 2.6 ± 0.7 days.
Conclusion: Laparoscopic splenectomy for hematological diseases may be considered as first-line therapy with less hospital stay and morbidity