• Title/Summary/Keyword: splenectomy

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A Case Report of the Mesocaval Shunt in the Failed Splenorenal Shunt (선천성 문정맥의 기형으로 인한 문맥압항진증에 시행한 Shunt 의 1례 보고)

  • 정성규
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.107-112
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    • 1972
  • Recently we experienced a case of the portal hypertension, extrahepatlc origin in the National Medical Center, Seoul. The case was a male aged 19 who was undergone the elective splenorenal shunt with splenectomy 9 years ago and emergency ligation of the coronary vein because of recurred variceal rupture 6 years later and had recurring esophageal varices with bleeding this time.At the age of 10 he had been occasionally suffering from nasal bleeding and visited to our Pediatric department, when there was encountered for the first time the splenomegaly, esophageal varices in the lower third esophagus on the esophagogram, and stenosis and kinking of the portal vein with rich collateral circulation on the splenoportography without hepatic functional impairment.The elective splenorenal shunt with splenectomy was undergone under the diagnosis of portal hypertension due to congenital anomaly of the portal vein and postoperatlvely no troubles had been obtained until postoperative 1st attack of massive hematemesis due to esophagenl variceal rupture recurred about 6 years later which was confirmed by control esophagogram and it was resulted by stenosis of previous anastomotic site of the splenorenal shunt.Then emergency ligation of the coronary vein was only made for bleeding control and no episodes of hematemesis had been encountered thereafter until April 1972 about 3 years after the 2nd operation, when hematemesis recurred again. In this time, recurring esophageal varices were noted in the lower third esophagus on the control esophagogram and he was employed side to end mesocaval shunt as the final step of portal decompression,and following results were obtained. 1] No postoperatlve troubles as leg edema or pain: Postoperatively leg elevation and elastic bandage on the both legs were employed until discharge. 2] During operation the portal pressure was 300 mm $H_2O$ and immediately lowered to 170 mm $H_2O$ after shunt.

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A Case with Splenic Tuberculosis (비장 결핵)

  • Lee, Doo-Sun;Myong, Na-Hye
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.200-203
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    • 1995
  • Splenic tuberculosis is an uncommonly considered diagnosis in clinical practice. This is a case report of splenic tuberculosis in a 13-year-old boy who was seronegative to HIV. He was just well until 7 days prior to this admission when he started to feel epigastric and left subchondral pain. Chest X-ray was not pathological. Abdominal ultrasonography showed slight splenomegaly with multiple hypoechoic nodules and abdominal CT disclosed multiple irregular hypodense lesions in the spleen. Radiological interpretation suggested the possibility of lymphoma or metastatic malignancy. Splenectomy was done and the histopathological findings showed extensive chronic granulomatous inflammation compatible with tuberculosis. Splenic tuberculosis must be included in the differential diagnosis of hypoechoic and hypodense lesions by means of sonography and computed tomography, respectively.

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Surgical Treatment of Thoracic Injuries Combined with Abdominal Injuries (복부 손상을 동반한 흉부손상 환자의 외과적 치료)

  • Jeong, Seong-Un;Kim, Byeong-Jun;Lee, Seong-Gwang
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.842-846
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    • 1995
  • Recently, the trauma patients have been markedly increasing due to the vast increase of traffic accident, industrial disaster, incidental accident and violence. The authors have analysed of 22 patients of thoracic injuries combined with abdominal injuries and summarized as follows. The ratio of male to female was 3.4:1 and their age distribution was from 5 years to 68 years and mean age was 34.4 years. The etiologies of injury were traffic accident, stab wound, fall down and violence. Associated injuries were fractures, bowel perforation, kidney rupture, head injury, liver laceration, spleen rupture and so forth. The modes of treatment were closed thoracostomy, repair of diaphragm, ruptured bowel repair, explo-thoracotomy, splenectomy, hepatic lobectomy in this order of frequency. The postoperative complications were atelectasis, wound infection, pneumonia, empyema, acute renal failure, respiratory failure and bleeding. The mortality rate was 13.6% [3/22 and the causes of death were respiratory failure 1 case, acute renal failure 1 case and hypovolemic shock 1 case.

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Successful Heart Transplantation across an ABO Blood Group Barrier -One case report- (ABO 부적합성 심장이식술 -치험 1례 보고-)

  • 원태희;신윤철
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.322-325
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    • 1996
  • ABO incompatible allografting is contraindicated in most organ transplantations including heart because of the hyperacute and acute rejections caused by preexisting antibodies. However several reports showed that ABO incompatible organ transplantation could be managed successfully by plasmapheresis, antibody adsorption, immunosuppression, splenectomy, and so on. We experienced one success in ABO incompatible cardiac transplantation by means of plasmapheresis and immunosuppression. However, this does not justify heart transplantation across ABO blood group barriers. Because the effect of ABO incompatibility on continued acute rejection or chronic rejection has not been fully understood, long-term follow-up study is required.

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A Case of Idiopathic Thrombocytopenic Purpura (특발성 혈소판 감소성 자반증에 대한 고찰 및 증례 1예)

  • Hong, Sang-Hoon
    • The Journal of Internal Korean Medicine
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    • v.21 no.4
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    • pp.677-682
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    • 2000
  • Idopathic thrombocytopenic purpura(ITP) is the most common autoimmune hematologic disorder. The use of glucocorticoids and splenectomy have been the mainstays of treatment of ITP Some studies have shown that chinese herbal medicine treatment increase platelet count level of ITP patients. However, there is a lack of research considering oriental herbal medicine with ITP, in korea. A 33-year-old female who had diagnosed ITP on Mar 1999, was treated herbal medicine for decreased platelet count level$(34000/{\mu}l)$ that was identified on regular follow-up. this patient's platelet count level was get to normal$(139000/{\mu}l)$ by BuQiSheXue(補氣攝血) pattern herbal medicine that composed with Radix Astragali(黃?), Herba Agrimoniae(仙鶴草), Rhizoma Atractylodis Macrocephalae(白朮), Radix codonopsis(黨參), etc. I report the case with a review of literature.

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Hematoma in Neck after Stellate Ganglion Block (성상신경절 차단후에 발생한 경부혈종)

  • Han, Young-Jin;Choi, Huhn
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.270-272
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    • 1994
  • A 43 year old male patient injured in a traffic accident was admitted to the department of general surgery for the treatment of spleen rupture and multiple rib fractures. After subphrenic abscess occurred after splenectomy was treated. After 50 days of admission, left facial palsy occurred with sensory neural hearing loss, and tinnitus by longitudinal fracture of left temporal bone. The patients was consulted to pain clinic for further evaluation and treatment. The patient was treated with stellate ganglion block with 1% lidocaine 6ml one time daily. On 19th day, stellate ganglion block was given as usual, and the patient complained of pain in the neck and headache the next day. Two days later, mild fever elevation and hematoma in the neck were found. Hematoma was drained with hemovac. Ruptured muscular branch of vertebral artery was ligated surgically but the ligation was released in the next day and the hematoma was removed and the artery religated. Five units of packed RBC were transfused during the period and the patient was discharged without any sequelae.

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Longterm Benefit and Unmet Needs in Enzyme Replacement Therapy of Gaucher (고셔병 환자에서 효소대체치료의 장기적 효과와 한계)

  • Kim, Yoo-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.42-47
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    • 2014
  • Gaucher disease is a multisystemic disorder arising from a deficient activity of the lysosomal enzyme glucocerebrosidase, which leads to accumulation of glycosylceraide and other glycolipids in the regiculoendothelial system. The characteristics of Gaucher disease are anemia, thrombocytopenia, hepatosplenomegaly, and skeletal disease. Enzyme replacement therapy (ERT) has been proven to prevent progressive manifestations of Gaucher disease and effective in improving anemia, thrombocytopenia, bone markers and biomarkers. However, some patient needs still remain unmet because of the inaccessibility of certain sites including brain, bone and various organs. ERT could not Improve the irreversible lesion such as liver fibrosis, hepatopulmonary syndrome, and necrosis or infarction of bone and other organs. Adult patients with Gaucher disease should be screened for longterm complication such as bone disease, pulmonary hypertension, gallstone, and cancer, especially in patients with splenectomy. Parkinsonism and polyneuropathy was also reported among patients with type 1 Gaucher disease, but ERT does not improve neurological function. We need to review the benefits and unmet needs of ERT in Gaucher disease.

Splenic Infarction due to Torsion of Wandering Spleen - A Case Report - (유주 비장의 염전에 의한 비장 경색 - 1예 보고 -)

  • Kim, Hye-Jin;Choe, Byung-Ho;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.183-188
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    • 2008
  • Wandering spleen is very rare condition in children characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. We experienced a case of splenic infarction due to torsion of a wandering spleen in a 6-year-old boy who presented with fever, vomiting, and abdominal pain of 2 day's duration. On physical examination, there was severe tenderness in the left upper quadrant of the abdomen. The plain abdominal radiograph showed marked colonic gaseous distension. Contrast-enhanced abdominal computed tomography scan showed decreased density of spleen in the normal position, consistent with infarction. At emergency laparotomy, a wandering spleen twisted $360^{\circ}$ on its pedicle was found. Despite splenic detorsion, blood flow could not be restored. Splenectomy was therefore performed. The child was discharged 7 days after surgery without any complications.

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Thoracic Splenosis after Splenic and Diaphragmatic Injury

  • Ha, You Jin;Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.47-50
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    • 2019
  • Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.

Splenic smooth muscle tumors in 7 dogs: case reports

  • Yim, So-Jeong;Kim, Nakhyoung;Kim, Jae-Hoon;Jung, Ji-Youl
    • Korean Journal of Veterinary Research
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    • v.62 no.2
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    • pp.16.1-16.4
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    • 2022
  • We describe 7 cases of splenic smooth muscle tumors in dogs. Histopathological and immunohistochemical analysis revealed that 6 cases were diagnosed as splenic leiomyosarcoma and 1 case as leiomyoma. All dogs underwent splenectomy without chemotherapy, and one of them was euthanized 2 months after surgery because of hepatic metastasis. Of the remaining 6 dogs, 5 died in the postoperative period and only one dog survived > 4 years. The median survival of the 6 dogs was 16.9 months. To the best of our knowledge, this is the first detailed study on splenic smooth muscle tumors in dogs in Korea.