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Article
SPLENIC TORSION, AN UNUSUAL CAUSE OF ACUTE ABDOMEN

Authors: Hashim S Alkhayat --- Jasim D Saud
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 2 Pages: 118-121
Publisher: Basrah University جامعة البصرة

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Abstract

Wandering spleen is a clinical rarity, torsion of a wandering spleen is a rare cause of an acuteabdomen. The etiology of wandering spleen is not precisely understood and this clinicalcondition presents a diagnostic challenge for clinicians. Available treatment options includesplenectomy. This is the first reported cases of such an anomaly in our hospital.

Keywords

SPLENIC --- TORSION


Article
Splenic Injuries atAl-Kadhimiya Teaching Hospital

Authors: Nahidh A. Abdulshaheed ناهد عداي عبد الشهيد --- Anees K. Nile انيس نايل --- Hikmat A. Hatam حكمت حاتم
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2009 Volume: 5 Issue: 1 Pages: 83-90
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The spleen is the most common solid organ injured in patients who had sustained abdominal trauma. Such injuries to the spleen represent approximately one quarter of all blunt injuries of the abdominal viscera.Due to its remarkable vasculature and its fragile structure, splenic rupture is the most widespread cause of intra-abdominal hemorrhage.Objective: To assess the magnitude of splenic injury, the management of splenic injury, and to evaluate the postoperative complications.Methods: A prospective study of 57 cases of splenicinjury was performed in Al-Kadhimiya TeachingHospital during the period between the 1st of October2004 and the 1st of October 2006. Statistical analysiswas then performed to identify the causes, managementand postoperative complications. Splenic injuries weregraded into 5 grades.Results: The highest incidence of splenic injury was recorded in age group s31-40 year. Penetrating injury was much more common than blunt trauma (73.68% versus 26.31%).Fifty patients (87 %) were diagnosed by exploratory laparotomy, ultrasonography in 5 patients (8.77 %), CT scan was positive in 2 patients (3.5 %). Associated injuries were recorded in 41 patients 71.92%. Pulmonary complications were the most frequent complications (18 patients, 31.57 %).Conclusion: Splenic injuries are common surgical problems in Al-Kadhimiya Teaching Hospital. Still there are many difficulties in establishing the diagnosis of the splenic injury with shortage in the new diagnostic modalities especially (CT -Scan, MR1 and even U/S scan) in the emergency situations.In spite of the dangerous post-operative complications of splenectomy, it is still the most commonly performed surgical procedure in cases of splenic injury.

Keywords

Spleen --- Splenic Injury --- Splenectomy --- Repair


Article
Splenic abscess: A rare presentation

Author: Dr. Najeeb S. Jabbo
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 1 Pages: 65-67
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Splenic abscess is a rare entity with a wide variability of causative pathogens Its reported mortality rate is still high, up to 47%, and can potentially reach 100% among patients who do not receive antibiotic treatment. The timely and widespread use of imaging methods (eg, computed tomography [CT] scanning, ultrasonography) facilitates early diagnosis and guides treatment, thus improving the prognosis. We are reporting a 42-year-male patient presented with an abscess in the spleen. The etiology was due to typhoid fever. It was diagnosed by CT-scan and treated by splenectomy. A review of the modalities of treatment is discussed


Article
Management Approaches of Splenic Surgery

Authors: Issam Salih Abduljabbar Al-Janabi --- Maha Abduljabbar Lattuf Al-Rudaini --- Hareth Abbas Hassan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 2 Pages: 235-242
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Splenic surgery is common surgical procedure with different indications and approaches that carries some potential complications which can be avoided. OBJECTIVE: To analyze the indications, management and complications of splenic surgery. PATIENTS AND METHOD: Prospective study conducted in the 3rd unit of general surgery department of Baghdad teaching hospital & private hospital over a period of 3 years, from the first of January 2008 till the end of December 2011. Ninety six patients with traumatic and non traumatic splenic pathologies were evaluated and followed up. RESULTS: This study includes ninety six patients with different splenic pathologies were included in this study with mean age of 23.69 ± 14.853 years. Sixty five patients with non traumatic pathology were treated by elective surgery with mean age of 20.25 ± 12.857 years, fifty eight of them by open splenectomy, four by laparoscopic splenectomy, two cystectomy of hydatid disease of the spleen and one by drainage of splenic abscess. Idiopathic thrombocytopenic purpura (I.T.P.) was the most common indication of non-traumatic splenectomy followed by thalassemia. Thirty one patients with trauma with mean age of 30.90 ± 16.325 years (16 of them had penetrating injury and 15 had blunt trauma) were treated by emergency splenectomy in 24 patients, splenorrhaphy in 5 and conservative treatment in 2 of them. Post-operative complications occurred in 25(26%) patients, pulmonary complication was the most common one, and the overall mortality was 5.2%.CONCLUSION: Splenectomy still the most common option in traumatic cases but the availability of new diagnostic imaging might improve the future results to conserve some injured spleen and there is a place for laparoscopic approach in selected cases of elective splenectomy and splenic preservation in some splenic hydatid cyst.


Article
Double spleen in Baladi goat in Beni-Suef governorate –Egypt: case report
الطحال المزدوج في الماعز البلدي في مدينة بني سويف – مصر: تقرير حالة

Author: R.A. Mohamed رضا عبد لله محمد
Journal: Iraqi Journal of Veterinary Sciences المجلة العراقية للعلوم البيطرية ISSN: 16073894 Year: 2014 Volume: 28 Issue: 2 Pages: 105e-107e
Publisher: Mosul University جامعة الموصل

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Abstract

The report of the occurrence of accessory spleen in domestic animals is rare in the literatures. We report a case of anaccessory spleen in Baladi goat. Accessory spleen was present near the cranial groove of the rumen on the ventral ruminal sac.It was supplied by accessory splenic artery which originated from the splenic artery after giving off the epiploic branch.

وجود الطحال الاضافى في الحيوانات المستأنسة نادر الحدوث. لقد تم إيجاد حالة بھا طحال اضافى في الماعز البلدي. ھذا الطحال الاضافى وجد قريبا من الأخدود الامامى للكرش على الكيس الكرشى البطنى وتتم تغذيته بالشريان الطحالي الاضافى الذي نشا من الشريان الطحالي بعد إعطاء الأخير الفرع الثربى.


Article
Primary splenic follicular lymphoma treated with splenectomy and adjuvant chemotherapy; a case report

Authors: Anju A. Abraham --- Sreejith G. Nair --- Rony Benson --- Jayasudha A. Vasudevan
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2018 Volume: 7 Issue: 2 Pages: 90-92
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Primary splenic lymphoma is a rare low‑grade non‑Hodgkin’s lymphoma. This is a case of a 52‑year‑oldwoman who had an incidental detection of a lesion in the spleen during evaluation for fever whichwas found to be a case of primary grade III follicular lymphoma of the spleen. The patient wasstarted on rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapypostsplenectomy. Rituximab was not added initially as the patient had a high viral load of hepatitis Bvirus (HBV). The patient completed six cycles of chemotherapy and rituximab added after four cycleswhen HBV DNA titer became negative. The outcome in patients with primary follicular lymphoma isgood with splenectomy followed by multi‑agent chemotherapy.


Article
Characteristics of splenic marginal zone lymphoma: Clinical, hematologic, and flow cytometry findings of 34 cases

Authors: Wafaa Mohammed Al‑Anizi --- Mohammed Abdul Rassoul Al‑Mashta
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2017 Volume: 6 Issue: 2 Pages: 84-89
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

BACKGROUND: Splenic marginal zone lymphoma (SMZL) is a low‑grade disorder that regularlypresents with peripheral blood (PB) involvement. A precise description of clinical, laboratoryfeatures and immunophenotypic characterization of SMZL are still lacking. Here, we reviewed34 patients presenting with SMZL to describe the clinical, hematologic features, and flow cytometryimmunophenotypic findings of this type of lymphoma at diagnosis.OBJECTIVES: The aim of this study is to confirm that SMZL has a specific immunologic profile whichenables the hematopathologist and clinician to differentiate this low‑grade B‑cell lymphoma from otherB‑cell lymphoproliferative disorder, especially chronic lymphocytic leukemia and hairy cell leukemia,which could sometimes stimulate SMZL morphologically and to emphasize that a correlation ofimmunophenotypic findings, clinical, and hematologic features of patients plus careful morphologicalexamination of PB and/or bone marrow (BM) aspirate can lead confidently to the correct diagnosis.MATERIALS AND METHODS: Flow cytometry immunophenotypic findings of 34 cases of SMZL werereviewed. The analysis was performed by BD FACS Calibur™ and FACSCanto II flow cytometers.B lymphocytes were identified according to their Side-Scattered (SSC)/CD19 distribution. A markerwas considered positive when expressed in more than 20% of cells above the control.RESULTS: Median age was 60 years, range (35–84 years), both sexes were affected equally. Allpatients presented with splenomegaly, 71% of patients had absolute lymphocytosis and 88% ofpatients showed PB involvement. Seventy‑four percent of patients had anemia and (53%) of themhad thrombocytopenia. Cells from all cases expressed pan B‑cell antigens (CD19, CD20), 74% ofcases expressed CD79b and Human Leukocyte Antigen – antigen D Related (HLA-DR) expressedin nearly almost all cases (97%). Half of the patients expressed CD11c and SIgD, 41% expressedCD5 and FMC7 while CD25 and CD103 showed positivity in less than 5% of cases. Preferentialexpression of Kappa light chain was demonstrated, CD10 and CD38, SIgG were negative.CONCLUSION: SMZL has a distinct immunologic profile which if correlated with morphologic findingsof PB or BM aspirates, clinical and hematologic features can help to make the accurate diagnosisand lessens the need of further invasive diagnostic procedure.


Article
Splenectomy for isolated splenomegaly; experience with twelve patients
إستئصال الطحال في حالة تضخم الطحال المنفرد؛ خبرة عمل مع إثني عشر مريضاً

Authors: Ahmed A. Al Saffar احمد عبد المجيد الصفار --- Mohammed S. Abbas محمد سليم عباس --- Mazin A. Mohammed مازن عباس محمد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2014 Volume: 56 Issue: 1 Pages: 9-12
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Changes in the indication for splenectomy in hematology, especially in hematological malignancies, has been observed in the last 10 – 15 years. Yet splenectomy, as a diagnostic tool, is still an option in the management of isolated splenomegaly.Objectives: to describe the outcome of diagnostic splenectomy in the management of 12 patients presenting with isolated splenomegaly. Patients and methods: Between August 2005 and July2012, Twelve patients underwent splenectomy for diagnostic purposes in the hematology unit / Baghdad Teaching Hospital. Analysis of these patients was done with a median follow up of 16 months (6 months -4 years).Results: The median age was 46 years (range 25-68). The median duration of symptoms was 6.8 months (range 3-12) months. The median duration of follow up was 16 months. We had 8 females, and 4 males. Three patients were asymptomatic, but they had progressive enlargement of spleen over one month. The most common symptoms were malaise and abdominal pain, seen in 8 patients. The other less frequent symptoms were fever (5 patients), weight loss (5 patients), arthralgia (4 patients), while the bleeding manifestation was seen in one patient only. Anemia was seen in 5 patients, two had leucopenia, and two had thrombocytopenia. Focal lesions in the spleen were seen in two patients by ultrasound and CT scan. The results of bone marrow aspirate and biopsy, upper gastrointestinal endoscopy and serological tests for collagen vascular diseases all were unrevealing prior to splenectomy. The histopathological results were; Hodgkin disease(1 patient), intermediate grade Non-Hodgkin lymphoma(1 patient) , splenic marginal zone NHL(2 patients),Diffuse Large B Cell Lymphoma(1 patient), Gaucher's disease(1 patient), favor myeloproliferative disorders(1 patients), one patient had tuberculosis, while 4 patients ended with non-diagnostic results. Laproscopic splenectomy was done in one patient only. Postoperative complications were seen in 4 patients which were grade 1-2 bleeding and simple wound infection. During follow up one patient with undiagnostic reports proved to have collagen vascular disease & two patients developed lymphoma, and the last one developed features of myeloproliferative disorder.Conclusion: splenectomy for isolated splenomegaly has a significant impact on the management of a significant proportion of those 12 patients. Other investigations which help in the diagnosis of collagen vascular diseases, myeloproliferative disorders& lymphoproliferative disorders are needed before proceeding for splenectomy.Keywords: isolated splenomegaly, splenectomy, splenic lymphoma.

الخلفية العلمية: خلال السنوات الخمسة عشر الأخيرة, كان هنالك تغيرا واضحا في نسبة أجراء أستئصال الطحال في مجال أمراض الدم وخصوصا السرطانية. ولكن تبقى هذه العملية بقصد التشخيص لها دورا مهما في حالات تضخم الطحال المنفرد.الهدف من الدراسة: عرض دور عملية استئصال الطحال في علاج 12 مريضا يعانون من تضخم الطحال المنفرد.الطرق: ما بين اب سنة 2005 وتموز سنة 2012 في شعبة امراض الدم في مستشفى بغداد التعليمي, تم أجراء عملية رفع الطحال لأثني عشر مريضا يعانون من تضخم الطحال المنفرد, بعد سلسلة من الفحوصات المختبرية والشعاعية. تم ارسال النماذج للزرع النسيجي. وكانت فترة المتابعة تتراوح ما بين ستة أشهر ولغاية أربع سنوات(بمعدل 16 شهر).النتائج: متوسط العمر للمرضى كان 46 سنة(25-68 ), ومتوسط فترة شكوى المرضى من مختلف الأعراض كان 6.8 شهرا. أحتوت الدراسة على ثماني نساء وأربعة رجال. ثلاث مرضى كانوا لايعانون من اي اعراض سوى تضخم الطحال المتزايد. تراوحت بقية الأعراض بنسب متفاوته, مثل ألم البطن, العياء, ارتفاع درجات الحرارة , فقدان الوزن, وألم المفاص كانت علامات النزف واضحة في مريض واحد فقط.فيما عدا فقر الدم في ستة مرضى ونقص الأقراص في أربعة مرضى, كانت جميع التحاليل الأخرى طبيعية. أجريت العملية عن طريق فتح البطن, وفي حالة واحدة كانت بالجراحة المنظارية. نتيجة الفحص النسيجي كانت مرض هوجكن عدد واحد, ورم لمفاوي متوسط الحدية عدد اثنان, ورم لمفاوي طحالي عدد اثنان, مرض متشعب نخاعي مريض واحد, مرض كوشر عدد واحد, احتقان الطحال عدد واحد, وتدرن منتشر عدد واحد. بينما كان التحليل النسيجي لايشير الى تشخيص معين في اربع مرضى. التداخلات بعد العملية سجلت في اربع مرضى وكانت بدرجة 1-2 وعبارة عن نزف والتهاب الجرح البسيط. تم تسجيل تحسن في صورة الدم لجميع المرضى بعد اوقات مختلفه من العملية.الاستنتاج: كان لعملية رفع الطحال للمرضى الاثني عشر المصابين بتضخم الطحال المنفرد, أثرا واضحا في تشخيص ومعالجة هؤلاء المرضى. ولكن يبفى العمل على توفير الفحوصات المتقدمة وخصوصا الكاشفه عن أمراض النسيجين الضام والوعائي وأورام الدم المختلفة ضرورية قبل الأقبال على العملية.الكلمات الرئيسية: تظخم الطحال المنفرد, استئصال الطحال, الورم اللمفاوي الطحالي.

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