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At least 1,513 records · Page 84Linked to original sources
PubMed2003

[Splenectomy in a dressage pony: end of sports career?].

A 14-year-old Arabian cross-bred gelding was referred to the University Clinic because of mild, recurrent signs of colic for 5 days. The pony showed icteric mucous membranes, haemolytic blood, and dark coloured urine. Internal examination did not give a clear diagnosis. Unidentified intra-abdominal strands were found and haemorrhagic abdominocentesis led to the decision to perform an exploratory laparatomy. An extremely enlarged spleen was the sole finding. A splenal biopsy sample was taken and surgery was completed. The pony remained colicky, so the spleen was examined by ultrasonography. After this examination, the tentative diagnosis 'tumour of the spleen' was made and splenectomy was performed. Pathological examination of the spleen revealed splenomegaly caused by infarctions of unknown origin. Eight weeks after surgery, the pony started again in dressage competition. Six months after splenectomy, the pony won the provincial dressage competition.

Animals↗
PubMed1992

[The effect of splenectomy on the immune status of children with active liver cirrhosis].

A complex study of parameters of the systemic cell humoral immunity, secretory immune system, functional state and phagocytic activity of neutrophils as well as activity of the complement and its C3, C4 components in 28 children with active cirrhosis of the liver has shown that the disease was accompanied by a generalized disturbance of the immunity mechanisms. Splenectomy in these children was shown to have favorable influence on the immune status, to reduce activity of the immunopathological process in the liver. At the same time, splenectomy results in continuous suppression of neutrophilic phagocytosis which may be a cause of the development of postsplenectomy septic conditions.

Adolescent↗
PubMedDate not supplied

[Recurrence in post-splenectomy spherocytosis anemia due to presence of accessory spleens].

A young female patient had a recurrence of severe spherocytic anemia there years after having been submitted to splenectomy. The presence of two accessory spleens with a size of 3.5 cm and 4.0 cm, was demonstrated by technetium scanning and ultrasound images. Surgical removal of these noduli resulted again in prompt recovery. The development of the spleen beings in the fifth week of intrauterine life at the dorsal mesogastrium. The lack of fusion of splenic lobuli is responsible for the occurrence of accessory spleens. A surgeon performing splenectomy for the treatment of hemolytic anemia should always search for possible existences of accessory spleens.

Adult↗
PubMed1992

[Improvement of pancytopenia and articular and by splenectomy in a patient with Felty's syndrome].

A forty seven year-old woman with a 18 years history of rheumatoid arthritis presented with recurrent infection and pancytopenia. A diagnosis of Felty's syndrome was made hand on clinical and laboratory findings. In spite of drug therapy using nonsteroidal anti-inflammatory drugs, D-penicillamine and corticosteroid, the hematological abnormalities and active joint symptoms continued. Recurrences of severe bacterial infection and the rupture of esophageal varices necessitated splenectomy. Soon after the operation, dramatic improvement of hematological abnormalities were observed. Furthermore, after 3 months postoperatively, marked decrease in rheumatoid activities and disappearance of subcutaneous nodules were noticed. Titer of rheumatoid factor also showed a significant reduction and became negative 6 months after the operation. Although the efficacy of splenectomy on hematological abnormalities in Felty's syndrome has been well documented, its effect on rheumatic disease has not been clarified. The case presented here might suggested that suppression of reticuloendothelial system may have therapeutic effects in rheumatoid arthritis. The possible mechanisms involved in these findings have been discussed.

Felty Syndrome↗
PubMed2003

General anesthetic management for diagnostic splenectomy in a patient with paraneoplastic pemphigus.

Paraneoplastic pemphigus (PNP) is an autoantibody-mediated mucocutaneous blistering disease that often occurs with confirmed or occult malignancy. It is often accompanied by extensive eruption of respiratory mucosa and can lead to respiratory failure. The indications for anesthetic management in patients with PNP are rare due to the high risk of generating further eruption of respiratory mucosa during intubation, with potentially disastrous consequences. We report the anesthetic management in a 43-year-old woman with PNP scheduled for diagnostic splenectomy. The surgery was postponed due to persistent hoarseness, diffuse oral-pharyngeal mucositis, and laryngeal erosion. Methylprednisolone 40 mg 3 times daily was prescribed for controlling the mucosa lesions. Two weeks later, after the improvement of mucosal lesions, direct laryngoscopic intubation and the scheduled splenectomy were performed under general anesthesia. Pathology of the spleen showed low-grade B-cell lymphoma had induced PNP. Flexible fiberoptic bronchoscopic examination revealed neither bleeding nor bullae formation in the trachea either immediately after intubation or before extubation. The tracheal mucosa is highly susceptible to mechanical stimulation with direct laryngoscopic intubation. Cuff inflation and positive pressure ventilation, awareness of the disease characteristics of PNP, a sufficient course of steroid therapy beforehand, and adequate mucosal protection are essential to the uneventful anesthetic management of the patient with PNP involving the respiratory tract mucosa.

Adult↗
PubMedDate not supplied

[Subtotal splenectomy for large splenic cyst].

Fulminant sepsis described in childhood has long stimulated surgeons to attempt partial or total preservation of the spleen when possible. Persistence of splenic tissue ensures preservation of the immunological competence of the organ. Total splenectomy ought to be avoided in the first 10 years of life; in subsequent years an attempt to partially preserve the organ is to be recommended. A segmental arterial vascularization with avascular interlobar planes has been demonstrated in the spleen allowing partial resection of the organ. We report a case of a voluminous epithelial splenic cyst in a teenager removed by subtotal splenectomy.

Adolescent↗
PubMed1992

Ultrasonic surgical aspirator in cytoreduction of splenic metastases to avoid splenectomy.

The Cavitron Ultrasonic Surgical Aspirator (Cavitron) was used to reduce the volume of splenic metastases in seven patients. Six patients had epithelial carcinoma of the ovary, and one had peritoneal mesothelioma. All patients had stage IIIC disease. Initially, six patients had malignant disease > 15 mm in diameter (of any single nodule), and one had disease 6-15 mm in diameter. In order to avoid resection of the spleen, cytoreduction could not be performed by standard means. After using the Cavitron, three patients had no gross residual disease, and four patients had disease 1-5 mm in diameter. No complication resulted from cytoreduction of splenic disease using the Cavitron, and splenectomy was not performed in any case. The Cavitron is invaluable in obtaining minimal residual disease of splenic metastases without performing splenectomy.

Adenocarcinoma↗
PubMed2003

Combined needlescopic cholecystectomy and laparoscopic splenectomy for the treatment of thalassaemic splenomegaly and cholelithiasis.

Gallstone disease is a common association in patients with haematological splenomegaly. When indicated, simultaneous splenectomy and cholecystectomy should be performed and traditionally this is accomplished by open surgery. We report a 17 year old thalassaemic girl with splenomegaly complicated by gallstone pancreatitis. We treated her with a combination of needlescopic cholecystectomy and laparoscopic splenectomy as well as delivering the huge spleen via a pfannenstiel incision to hide the scar. We believe this technique is an acceptable alternative mainly for rapid delivery of the spleen and to minimize visible scars hence improving cosmesis.

Adolescent↗
PubMed2004

Portal vein thrombosis after splenectomy for beta-thalassemia major.

Portal vein thrombosis is a recognized complication after splenectomy in beta-thalassemia major due to the chronic hypercoagulable state which has been recognized to exist in childhood thalassemia and contribute to thromboembolic events. We are reporting one patient with beta-thalassemia major developed portal vein thrombosis following splenectomy.

Abdominal Pain↗
PubMed2003

[Evaluation of the immune system following splenectomy in childhood: preliminary study].

The authors would like to point out a possibility of immune system disturbances (especially lymphocyte T), severe infection occurring in patients following splenectomy. Five children following splenectomy due to severe spherocytosis were studied. In all children serum level of IgA, IgG, IgM immunoglobulins, phagocytic index, Hamburger count and lymphocyte antigen surface expression CD3, CD4 CD10, CD19, CD20, CD29, CD45RA, CD56 were evaluated. In comparison to control group, median numbers of lymphocyte T CD3 (p < 0.05), lymphocyte CD4 (p < 0.05), lymphocyte T CD4CD29 (p < 0.001) and percentage of cells reacting with z CD4CD45RA (p < 0.001) were significantly lower in splenectomized children, whereas number of NK cells occurred to be noticeable higher (p < 0.001). Immunoglobulins' levels, Hamburger count, phagocytic index and percentage of lymphocyte CD8, CD19 and CD20 did not differ between groups. On the basis of the results, the authors recommend the necessity of routine vaccination in this group of patients against most common pathogens.

Antigens, CD↗
PubMed1992

Perioperative complications of splenectomy for hematologic disease.

A 15-year study of perioperative complications was carried out in 142 adults who underwent splenectomy for hematologic disease at the University of Alberta Hospital in order to obtain recent statistics on morbidity and mortality. The patients were grouped into four diagnostic categories: idiopathic thrombocytopenic purpura (71 patients), lymphoproliferative disorders (34 patients), myeloproliferative disorders (12 patients) and miscellaneous disorders (25 patients). Splenectomy was carried out for therapeutic reasons in 93% of patients and to establish a diagnosis in 7%. The overall complication rate was 22% (31 of 142) and the death rate was 6% (7 of 142). Infection accounted for 42% of the complications. Steroid or antibiotic therapy preoperatively did not significantly affect the infection rate. Drains, if removed within the first week, also did not affect the postoperative infection rate. Spleen size and the interaction between diagnosis and the presence of thrombocytopenia were predictors of the need for intraoperative transfusion.

Adult↗
PubMed1992

[The characteristics of the clinical course of lymphosarcomas when using combined therapy including splenectomy].

The authors relate the results of a clinico-morpho-instrumental analysis of the clinical course of lymphosarcomas in 38 patients with different morphological patterns of the disease with primary injury to the spleen. The patients received multimodality therapy including splenectomy. It has been established that later the short-term effect of splenectomy permits the implementation of different polychemotherapy programs, favouring a better lymphosarcoma prediction.

Adult↗
PubMed1992

Chediak-Higashi syndrome: clinical, hematologic, and immunologic improvement after splenectomy.

A 10-year-old boy with Chediak-Higashi syndrome in accelerated phase failed to respond to treatment with ascorbic acid, vincristine, and prednisone. Splenectomy resulted in clinical, hematologic, and immunologic improvement: his leukocyte chemotactic and phagocytic functions returned to normal. We suggest that splenectomy be considered in treatment of the accelerated phase of Chediak-Higashi syndrome unresponsive to other forms of therapy.

Antibody Formation↗
PubMed1992

Splenectomy as treatment for nonhealing soft tissue defect after total knee arthroplasty in a patient with Felty's syndrome.

We describe the apparent remarkable effect of splenectomy on wound healing in a patient with rheumatoid arthritis and Felty's syndrome. The patient had previously undergone a knee replacement with 4 months of failure of the surgical wound site to heal or close. The wound, which had broken down and dehisced on 3 separate occasions after plastic surgical attempts at closure, healed cleanly and without recurrence within 3 weeks of splenectomy and plastic repair at the same operation.

Aged↗
PubMed2004

[Effectiveness of splenectomy in high-risk patients needing surgery].

Splenectomy is a useful method of treatment in some hematological disorders (congenital microspherocytosis, ITP, hypersplenism). However in many clinical situations the unclear prognostic factors, bad patient's condition or non-typical disease's course may impede the decision to splenectomize. We present a history of three successfully splenectomized patients. In each of reported cases the complicated course required detailed disease and treatment analysis. Our results indicate that splenectomy should be considered as a therapeutic option in the thrombocytopenic patients. This group of patients should be immediately referred to specialized centres.

Aged↗
PubMed2004

Splenectomy in immune thrombocytopenic purpura: recent controversies and long-term outcomes.

Immune thrombocytopenic purpura (ITP) is an uncommon disorder but a relatively frequent cause of isolated thrombocytopenia. The pathogenesis of ITP involves enhanced platelet clearance, primarily in the spleen, caused by antiplatelet glycoprotein antibodies. Most patients with ITP respond transiently to an initial course of corticosteroids, although only 20% of adult patients achieve a durable remission after such therapy. Classically, patients who fail corticosteroid therapy undergo splenectomy, with approximately two thirds of these individuals maintaining partial remissions 5 years later. However, due to evidence suggesting a continuous relapse rate in splenectomized patients with ITP, in addition to the emergence of newer agents associated with durable remissions in ITP patients with intact spleens, the therapeutic approach to ITP is evolving. This article reviews the role of splenectomy in patients with ITP and reviews new approaches to management of ITP in patients who fail an initial trial of corticosteroids.

Humans↗
PubMed2004

Evaluation of liposome-encapsulated oxymorphone hydrochloride in mice after splenectomy.

The use of mice in biomedical research is increasing, largely due to the production and use of genetically engineered animals. Providing postoperative pain control in mice presents many challenges, and long-acting analgesic preparations would be advantageous for this species. A single subcutaneous injection of a liposome-encapsulated (LE) preparation of oxymorphone was compared with multiple injections of buprenorphine or saline in outbred mice undergoing splenectomy. Control groups were given isoflurane alone or isoflurane and an injection of LE oxymorphone but did not undergo surgery. The following parameters were evaluated for 5 days after surgery and were compared with presurgical baseline data for each group: food and water consumption, body weight, ethographic score, and voluntary exercise on a running wheel. Ethographic scores indicated less postsurgical pain in both groups of mice that received either analgesic preparation compared with mice that received only saline. However, mice given LE oxymorphone had superior postoperative recovery, as measured by wheel-running distance and body weight gain, compared with mice given buprenorphine or saline. Mice undergoing splenectomy had significant decreases in body weight, food and water consumption, voluntary exercise, and other normal behaviors. Administration of liposomal oxymorphone at the time of surgery improved postsurgical recovery as measured by these parameters compared with multiple injections of buprenorphine or saline alone. Administration of LE oxymorphone at the time of surgery improved postsurgical recovery, as measured by these parameters.

Analgesics, Opioid↗
PubMedDate not supplied

[Total splenectomy for a recurrent giant splenic cyst].

Primary splenic cysts are a rare finding. Some are large and require surgical removal. The Authors report a case of a recurrent huge splenic cyst in a 41-year-old female patient. A marsupialization was performed at another hospital 6 years before. Ultrasonography and computed tomography imaging revealed a cystic lesion in the spleen measuring approximately 20 cm in diameter. A total open splenectomy was performed. Postoperative course was uneventful. The histologic diagnosis was an epithelial cyst of the spleen with no atypical cells in the cyst wall, as previously found at the first operation. The epidermoid cysts have an epidermal lining, and prevention of recurrence is dependent on complete resection of the cyst wall preserving, whenever possible, the splenic tissue. Recurrence can be avoided with partial splenectomy in polar localization of the cyst, or complete removal of the cyst by "peeling" it off the splenic parenchyma. Marsupialization of the cyst, either via a laparoscopic or an open approach, is often ineffective.

Adult↗