• Journal of Trauma and Injury
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• 제23권2호
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• pp.192-195
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• 2010

Splenic rupture is a frequent surgical emergency in blunt abdominal trauma patients. There are several treatment options, including conservative treatment, a partial splenectomy, splenorrhaphy, and a splenectomy for splenic injury. Although reports on the safety and the efficacy of an elective laparoscopic splenectomy are abundant in the literature, a laparoscopic splenectomy for a ruptured spleen has only been reported in a few cases. We report a case of a laparoscopic splenectomy in the patient with Grade III traumatic splenic injury. To our knowledge, this is the first report in which a laparoscopic splenectomy was performed in Korea for the treatment of a traumatic splenic injury.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권2호
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• pp.147-153
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• 2018

Epstein-Barr virus (EBV) infection can be presented with various clinical manifestations and different levels of severity when infected. Infectious mononucleosis, which is most commonly caused by EBV infection in children and adolescents, is a clinical syndrome characterized by fatigue, malaise, fever, sore throat, and generalized lymphadenopathy. But rarely, patients with infectious mononucleosis may present with gastrointestinal symptoms and complicated by gastritis, splenic infarction, and splenic rupture. We encountered a 16-year-old girl who presented with fever, fatigue, and epigastric pain. Splenic infarction and EBV-associated gastritis were diagnosed by using esophagogastroduodenoscopy and abdominal computed tomography. Endoscopy revealed a generalized hyperemic nodular lesion in the stomach, and the biopsy findings were chronic gastritis with erosion and positive in situ hybridization for EBV. As splenic infarction and acute gastritis are rare in infectious mononucleosis and are prone to be overlooked, we must consider these complications when an infectious mononucleosis patient presents with gastrointestinal symptom.

• Advances in pediatric surgery
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• 제6권2호
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• pp.143-148
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• 2000

Pseudoaneurysm of the splenic artery may arise from a vascular erosion by a surrounding inflammatory processes in acute and chronic pancreatitis. Rupture of the pseudoaneurysm may threaten the patient's life. Conservative management for massive hemorrhage may cause 100 percent mortality and even with prompt therapy there is a high mortality. Preoperative detection of bleeding source is desirable because of the difficult identification of the bleeding site at laparotomy. Angiographic identification and embolization of the hemorrhagic vessels in selected cases may obviate the risk of urgent surgery. The authors have recently managed a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography confirmed the diagnosis. We managed this child successfully with the urgent transcatheter arterial embolization followed by elective surgery.

• Tuberculosis and Respiratory Diseases
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• 제74권3호
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• pp.134-139
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• 2013

Splenosis is defined as an autotransplantation of the splenic tissue after splenic rupture or splenectomy, and occurs most frequently in the peritoneal cavity. Splenosis is usually asymptomatic and is found incidentally. We report a case of combined intrathoracic and intraperitoneal splenosis in a 54-year-old male who worked as a miner for 10 years in his twenties, and was a current smoker. He was referred to our hospital for further evaluation of an incidental left diaphragmatic mass. Positron emission tomography-computed tomography and bronchoscopy were performed to evaluate the possibility of malignancy. There was no evidence of malignancy, but the spleen was not visualized. Reviewing his medical history revealed previous splenectomy, following a dynamite explosion injury. Therefore, splenosis was suspected and technetium-99m-labeled heat-damaged red blood cell scan confirmed the diagnosis. Radionuclide imaging is a useful diagnostic tool for splenosis, which could avoid unnecessary invasive procedures.

• 한국임상수의학회지
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• 제13권1호
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• pp.87-92
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• 1996

A hemangiosarcoma in a 30 kg, 6-year-old German Shepherd dog showing signs of abdominal distension, anorexia and depression was diagnosed with clinicopathologic examination, abdominal radiographs and ultrasonographic assessmint. In abdominal radiographs, overall abdominal distension was seen. Stomach and some parts of small intestines were deviated caudo-ventrally by enlarged liver. The splenomegaly was also identified and descending colon was dislocated laterally by splenic mass. In ultrasonographic findings, abdominal fluid was identified. Hepatomegaly was seen and it was consisted of multiple, anechoic cysts. The spleen was enlarged and a large round mass with mixed echo pattern at the mid to tail portion of spleen was identified. Grossly, at necropsy, multi-sized cysts in which contained blood and fibrpus materials and some blood were seen in the cross section and it showed hard consistency. Also, lots of small red tumor nodules were dispersed on the serosal surface of the bladder, omentum, mesentery, diaphragm and peritoneum. In abdominal paracentesis, fluid having almost the same properties as circulating blood was identified. The hemoperitoneum was thought to be resulted from the bleeding into peritoneum owing to the rupture of cystic lesions located on the superficial liver area.

• Journal of Chest Surgery
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• 제20권4호
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• pp.839-846
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• 1987

The records of 10 patients with traumatic diaphragmatic hernia seen from November 1977 through July 1987 were reviewed. All the patients had a transdiaphragmatic evisceration of abdominal contents into the thorax. We treated 7 male and 3 female patients ranging in age from 3 to 62 years. In 8 patients, diaphragmatic hernia followed blunt trauma and in 2 patients, stab wounds to the chest. The herniation occurred on the right side in 3 patients and on the left side in 7. All the patients sustained additional injuries: rib fractures [7 patients], additional limb, pelvic and vertebral fractures [6], closed head injury [2], lung laceration [1], liver laceration [1], renal contusion [1], ureteral rupture [1], and splenic rupture [1]. Organs herniated through the diaphragmatic rent included the omentum [6 patients], stomach [4], liver [4], colon [3], small intestine [1], and spleen [1]. For right-sided injuries, the liver was herniated in all 3 patients and the colon, in 1. in the initial or latent phase, dyspnea, diminished breath sounds, bowel sounds in the chest were noted in 4 patients, and in the obstructive phase, nausea, vomiting, and abdominal pain were found in all 3 patients. Two patients had a diagnostic chest radiograph with findings of bowel gas patterns, and an additional 8 had abnormal but nondiagnostic studies. Hemothorax, pleural effusion or abnormal diaphragmatic contour were common abnormal findings. Three patients were operated on during the initial or acute phase [immediately after injury], 4 patients were operated on during the latent or intermediate phase [3 to 210 days], and 3 patients were operated on during the obstructive phase [10 to 290 days]. Six patients underwent thoracotomy, 2 required thoracoabdominal incision, and 2 had combined thoracotomy and laparotomy. Primary suture was used to repair the diaphragmatic hernia in 9 cases. One patient required plastic repair by a Teflon felt. Empyema was the main complication in 2 patients. In 1 patient, the empyema was treated by closed thoracostomy and in 1, by decortication and open drainage. There were no deaths.

• Investigative Magnetic Resonance Imaging
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• 제18권2호
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• pp.171-175
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• 2014

간문맥으로 파열된 췌장 가성낭종은 매우 드문 합병증이며, 자기공명영상으로 확진된 경우는 3예만 보고되어 있다. 저자들은 50세 남자 환자에서 가성낭종과 간문맥 사이에 형성된 누공을 자기공명영상을 이용하여 비침습적으로 확진한 증례를 보고한다. T2강조영상 및 자기공명 담체관조영술에서 간문맥, 상장간막정맥, 그리고 비장정맥 내에 액체신호가 보였으며, 가성낭종과 간문맥이 직접 연결된 소견을 보였다.

• Pediatric Infection and Vaccine
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• 제13권2호
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• pp.191-195
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• 2006

저자들은 임상적 소견과 검사실 소견에서 전염성 단핵구증으로 확진한 환아에게서 폐렴과 흉막 삼출액이 동반된 드문 1례를 경험하였다. 이에 문헌고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제37권6호
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• pp.355-359
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• 2020

Contrast-enhanced ultrasonography (CEUS) has been applied to evaluate parenchymal organs in human and veterinary medicine. However, to our knowledge, there is no report on the identification of active bleeding and the bleeding site in veterinary clinical patients. Herein, we describe the use of CEUS in two cases of abdominal bleeding caused by ruptured lesions with malignant abdominal tumors. One dog had a splenic hemangiosarcoma, which had metastasized to the liver; the other dog had hepatic cell carcinomas in the left hepatic lobe, which were lobectomized, and another nodule was identified in the right hepatic lobe. Immediately after the rupture of these oncogenic lesions was suspected, CEUS was performed to identify the bleeding sites. The active bleeding sites were confirmed by hyperechoic pooling signs in the arterial phase, and extravasation could be observed within the defects showing hypoechoic perfusions in the delayed phase of the CEUS. Microbubbles were also observed in the ascites; thus, CEUS could detect the presence of hemorrhage and accurately identify the bleeding site. Collectively, the study findings suggest the usefulness of CEUS in emergent situations as it enables rapid and noninvasive evaluation of bleeding points in case of active bleeding in dogs.

• Journal of Chest Surgery
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• 제43권2호
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• pp.224-227
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• 2010

호흡기와 위장관 사이의 누공은 염증이나 외상에 의하여 발생된다. 저자들은 기관지-흉강-위장-대장 누공이 있는 51세 남자 환자를 경험하였다. 호흡시에 만성적인 악취를 호소하던 환자는 30년 전 횡격막파열의 기왕력을 가지고 있었다. 횡격막 염증이 좌하엽 괴사를 유발하여 기관지-흉강강 누공을 만들었고, 위장의 분문부과 대장의 비장굽이부분에 천공을 유발하였다. 저자들은 좌하엽 절제술과 횡격막 복원, 위장관 수술을 시행하였다.