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Splenic embolization

Q A Hill, L C Harrison, A D Padmakumar, R G Owen, K R Prasad, G F Lucas, P Tachtatzis
OBJECTIVE AND IMPORTANCE: Transplantation-mediated alloimmune thrombocytopenia (TMAT) occurs when leukocytes transferred in a donor organ from a patient with immune thrombocytopenia (ITP), mount a response against recipient platelets. We present the first fatal case of TMAT following liver transplantation and review its aetiology and treatment. CLINICAL PRESENTATION: The liver donor had ITP and died from an intracranial haemorrhage. The recipient platelet count fell to 2 × 10(9)/l on post-operative day 2...
October 21, 2016: Hematology (Amsterdam, Netherlands)
Amit Shrivastava, Jagadeesh Singh Rampal, D Nageshwar Reddy, Guduru Venkat Rao
BACKGROUND: Gastro-Intestinal bleeding remains a frequent clinical dilemma and common cause of hospitalization, morbidity and mortality. CASE REPORT: We report a case of pseudo aneurysm of splenic artery developed after an episode of acute on chronic pancreatitis which was treated by direct percutaneous puncture of pseudoaneurysm and embolization by coils. CONCLUSIONS: The aim was to preserve the main splenic artery and avoid the complications of splenic artery embolization like infarcts and abscess...
2016: Polish Journal of Radiology
Melike Kalfa, Hayriye Kocanaoğulları, Gonca Karabulut, Hakan Emmungil, Celal Çınar, Zevcet Yılmaz, Sercan Gücenmez, Yasemin Kabasakal
Segmental arterial mediolysis (SAM) is a rare, nonarteriosclerotic, noninflammatory vascular disease and mostly affects medium-to-large sized abdominal arteries as well as presents with hemorrhages in the abdominal cavity. We report the case of a patient with SAM of the celiac, right renal, jejunal branch of the superior mesenteric, left gastric, and splenic arteries who was diagnosed by excluding other causes and in whom transcatheter embolization was performed in two different sessions, but he died because of an undefined reason...
September 2016: Eur J Rheumatol
Jason Reinglas, Kirstin Perdrizet, Stephen E Ryan, Rakesh V Patel
Splenosis, the autotransplantation of splenic tissue following splenic trauma, is uncommonly clinically significant. Splenosis is typically diagnosed incidentally on imaging or at laparotomy and has been mistakenly attributed to various malignancies and pathological conditions. On the rare occasion when splenosis plays a causative role in a pathological condition, a diagnostic challenge may ensue that can lead to a delay in both diagnosis and treatment. The following case report describes a patient presenting with a massive upper gastrointestinal bleed resulting from arterial enlargement within the gastric fundus secondary to perigastric splenosis...
2016: Clinical and Experimental Gastroenterology
Seiichiro Kojima, Hiroyuki Ito, Shinji Takashimizu, Hitoshi Ichikawa, Tomohiro Matsumoto, Terumitsu Hasebe, Norihito Watanabe
A 64-year-old woman treated for anemia and ascites exhibited hepatic encephalopathy. Abdominal ultrasonography and computed tomography (CT) showed communication between the portal vein and the middle hepatic vein, indicating an intrahepatic portosystemic venous shunt (PSS). Since hepatic encephalopathy of the patient was resistant to medical treatment, interventional radiology was performed for the treatment of shunt obliteration. Hepatic venography showed anastomosis between the hepatic vein branches, supporting the diagnosis of idiopathic portal hypertension (IPH)...
September 2016: Acta Radiologica Open
Daniel Martingano, Francis X Martingano, Rosemary Ruggiero-DeCarlo
Pregnancy-related rupture of an arterial aneurysm is an unusual occurrence associated with increased risk of morbidity and mortality. Various pregnancy-related physiologic changes appear to make pregnancy a high-risk situation for rupture of either preexisting arterial aneurysms or those that develop throughout the course of pregnancy. Splenic artery aneurysms are the most common (60%), followed by hepatic (20%), superior mesenteric (5.9%), celiac (4%), ovarian, uterine, and renal (<2%) artery. Even rarer are aneurysms involving the internal iliac artery and its branches, to which there is only one published case report...
September 2016: Obstetric Medicine
F Van der Cruyssen, A Manzelli
BACKGROUND: The spleen is the second most commonly injured organ in cases of abdominal trauma. Management of splenic injury depends on the clinical status of the patient and can include nonoperative management (NOM), splenic artery embolization (SAE), surgery (operative splenic salvage or splenectomy), or a combination of these treatments. In nonoperatively managed cases, SAE is sometimes used to control haemorrhage. However, the indications for SAE have not been clearly defined and, in some cases, the potential complications of the procedure may outweigh its benefits...
2016: World Journal of Emergency Surgery: WJES
P Zhu, Y Sun, S Zheng
Tricuspid valve endocarditis is mainly found in intravenous drug abusers, and with splenic infarction in obstetric and gynaecologic practice is rare. We report the case of a 37-year-old woman with tricuspid infective endocarditis and splenic infarction after an elective abortion. The infected tricuspid valve and infarcted spleen were removed at one-stage operation. Systemic circulation arterial embolism should be considered when treating patients with right-sided endocarditis and a history of obstetrical procedures...
February 18, 2016: West Indian Medical Journal
Jose Hugo M Luz, Paula M Luz, Edson Marchiori, Leonardo A Rodrigues, Hugo R Gouveia, Henrique S Martin, Igor M Faria, Roberto R Souza, Roberto de Almeida Gil, Alexandre de M Palladino, Karina B Pimenta, Henrique S de Souza
Systemic chemotherapy treatments, commonly those that comprise oxaliplatin, have been linked to the appearance of distinctive liver lesions that evolves to portal hypertension, spleen enlargement, platelets sequestration, and thrombocytopenia. This outcome can interrupt treatment or force dosage reduction, decreasing efficiency of cancer therapy. We conducted a prospective phase II study for the evaluation of partial splenic embolization in patients with thrombocytopenia that impeded systemic chemotherapy continuation...
September 9, 2016: Cancer Medicine
Christian Georg Blumentrath, Nils Ewald, Jasmina Petridou, Uwe Werner, Barbara Hogan
The overwhelming post splenectomy infection (OPSI) in splenectomised patients is a rare but severe infection mostly caused by encapsulated bacteria. We analyse the case of a 65-year-old female patient who was presented with clinical and laboratory findings indicating gastroenteritis. Two years years before admission, the patient underwent a splenectomy for a two stage splenic rupture following resuscitation for pulmonary embolism. Immunisation of the patient was complete and timely. As a result of the unspecific clinical presentation, there was a delay in administration of antibiotics...
2016: German Medical Science: GMS E-journal
Tao Xia, Jia-Yu Zhou, Yi-Ping Mou, Xiao-Wu Xu, Yu-Cheng Zhou, Chao-Jie Huang, Ren-Chao Zhang, Chao Lu, Rong-Gao Chen, Yun-Yun Xu
Celiac trunk aneurysms (CTAs) are rare and usually asymptomatic. Although most of these aneurysms can be treated with percutaneous embolization, some uncommon locations of the aneurysm may make this approach impossible. We report a patient with a celiac trunk aneurysm (CTA) and a proximal splenic artery aneurysm (SAA). Due to the size and location of these two aneurysms, after multidisciplinary discussion, endovascular management was considered inappropriate and they were treated by laparoscopic ligation of the two aneurysms and revascularization...
September 6, 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
Dimitrios Maras, Nikolaos Kontopodis, Athansios Dedes, Antonios Tsanis, Ioannis Mazarakis, Christos Gekas, Christos V Ioannou
We present an 82-year-old man with a history of hairy cell leukemia, having an 11-cm abdominal aortic aneurysm, who also had severe thrombocytopenia (about 20 000 platelets/μL) and splenomegaly at presentation. The patient had unfavorable anatomy for endovascular aneurysm repair, and therefore, an open procedure was planned. To reduce risk for perioperative bleeding and optimize patient preoperative status, a staged approach was employed. Initially, several sessions of embolization of 2 splenic artery branches were performed with the intent to decrease spleen size and to increase platelet count thus decreasing the perioperative bleeding risk...
August 2016: Vascular and Endovascular Surgery
Ziqing Yu, Bing Fan, Hongyi Wu, Xiangfei Wang, Chenguang Li, Rende Xu, Yangang Su, Junbo Ge
BACKGROUND: Systemic embolism, especially septic embolism, is a severe complication of infective endocarditis (IE). However, concurrent embolism to the brain, coronary arteries, and spleen is very rare. Because of the risk of hemorrhage or visceral rupture, anticoagulants are recommended only if an indication is present, e.g. prosthetic valve. Antiplatelet therapy in IE is controversial, but theoretically, this therapy has the potential to prevent and treat thrombosis and embolism in IE...
August 11, 2016: BMC Infectious Diseases
Kenichiro Uchida, Mitsuharu Hosono, Toshihiko Shibata, Daisuke Kaku, Tomonori Yamamoto, Takafumi Terada, Naoki Shinyama, Yasumitsu Mizobata
BACKGROUND: Mobile intra-aortic thrombus without atherosclerosis, aneurysm, or congenital coagulopathy is very rare, and there are few reports especially in young or middle-aged patients. Furthermore, there are presently no established guidelines or common strategies for the treatment of mobile intra-aortic thrombus. In this case report, we describe the first case of intra-aortic thrombus caused by secondary erythrocytosis and describe the recommended treatment strategy for intra-aortic thrombus...
2016: Journal of Medical Case Reports
Lacy E Lowry, Jonathan A Goldner
BACKGROUND: Spontaneous splenic rupture associated with anticoagulant use is a rare but potentially lethal disorder. Lack of prompt recognition can be associated with poor patient outcomes. The use of novel oral anticoagulants is becoming more common and thus consideration of this disorder while evaluating a patient who presents with abdominal pain while using these agents is extremely important. This is the first reported case of spontaneous splenic rupture associated with apixaban. CASE PRESENTATION: We describe the clinical case of an 83-year-old white man who complained of sudden severe abdominal pain 5 days into a hospital stay for acute-on-chronic congestive heart failure and exacerbation of chronic obstructive pulmonary disease...
2016: Journal of Medical Case Reports
Jenny Tannoury, Khalil Honein, Bassam Abboud
We are reporting the rare case of splenic artery aneurysm of 4 cm of diameter presenting as a sub mucosal lesion on gastro-duodenal endoscopy. This aneurysm was treated by endovascular coil embolization and stent graft implantation. The procedure was uneventful. On day 1, the patient presented an acute severe epigastric pain and cardiovascular arrest. Abdominal computed tomography scan showed an active leak of the intravenous contrast dye in the peritoneum from the splenic aneurysm. We performed an emergent resection of the aneurysm, and peritoneal lavage...
July 25, 2016: World Journal of Gastrointestinal Endoscopy
Özüm Tunçyürek, Pars Tunçyürek, Ersen Ertekin, Mustafa Gök, Emir Hüseyin Nevai, Füruzan Kaçar Döger, Yelda Özsunar
INTRODUCTION: Atraumatic spontaneous rupture of the spleen is an uncommon but fatal condition that may coexist with other disease. Our case was presented with obvious CT findings of a spontaneous rupture of the spleen. PRESENTATION OF THE CASE: A 75-year-old woman admitted to the emergency service with abdominal pain. Although there was no evident splenomegaly in the abdominal CT examination, the patient was diagnosed with diffuse large B-cell lymphoma, and densities in harmony with the free air were detected in the spleen and the abdomen...
2016: International Journal of Surgery Case Reports
Nikolaj Hjort Schmidt, Poul Edling
Acute splenic rupture can be a life-threatening condition which needs immediate attention. We report a case where parenchymal splenic lesions and subcapsular haematoma were developed after a patient was being hit with a water balloon from a slingshot. The patient was treated conservatively but developed an arteriovenous fistula which was treated with central arterial coiling. We discuss the need for acute computed tomography after relevant trauma as well as the evidence for follow-up scans and management of splenic pseudoaneurysms with splenic arterial embolization...
July 25, 2016: Ugeskrift for Laeger
Marius L Calin, Aziz Sadiq, Gabriel Arevalo, Rocio Fuentes, Vincent L Flanders, Niraj Gupta, Baongoc Nasri, Kirpal Singh
INTRODUCTION: Surgery for liver metastases in pancreatic neuroendocrine tumor (PNET) improves overall survival rate. We present the first case report for robotic multivisceral resection of distal pancreas, spleen, and left liver for metastatic PNET. MATERIALS AND METHODS: We present a case of 52-year-old female diagnosed with PNET in the pancreatic neck metastatic to the liver, responding to somatostatin and bland embolization, who underwent surgical debulking using da Vinci robotic platform...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Maximilian Kreibich, Bartosz Rylski, Julia Morlock, Friedhelm Beyersdorf, Martin Czerny
We report the case of a 61-year-old patient who presented with generalized malperfusion due to systemic embolization from a large, partially thrombosed aneurysm of the left upper pulmonary vein. When the patient arrived at our center, large thrombus formations were detected in the left atrium and the abdominal aorta, as well as the renal, iliac, and femoral arteries. Renal, splenic, and mesenteric ischemia was diagnosed with computed tomography. The patient was in shock, acute kidney failure, and in high vasopressor need...
August 2016: Annals of Thoracic Surgery
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