AIM: To evaluate the clinical application of serial operations with preservation of spleen. METHODS: Serial operations with preserving spleen were performed on 211 cases in our hospital from 1980 to 2000. The patient&...AIM: To evaluate the clinical application of serial operations with preservation of spleen. METHODS: Serial operations with preserving spleen were performed on 211 cases in our hospital from 1980 to 2000. The patient's age ranged from 13 to 56 years, averaging 38 years. Diseases included splenic injury in 171 cases, portal hypertension in 9 cases, splenic cyst in 10 cases, and the lesion of pancreatic body and tail in 21 cases. RESULTS: All the cases were cured, and 129 patients were followed up from 3 months to 3 years with the leukocyte phagocytosis test, detection of immunoglubin, CT,(99m)Tc scanning and ultrasonography. The results were satisfactory. CONCLUSION: The operations with preserving spleen were safe, feasible, and worth of clinical application.展开更多
Splenic rupture is a rare complication of diagnostic and therapeutic gastrointestinal endoscopy procedures.Herein,we report for the first time a case of splenic rupture following therapeutic retrograde double-balloon ...Splenic rupture is a rare complication of diagnostic and therapeutic gastrointestinal endoscopy procedures.Herein,we report for the first time a case of splenic rupture following therapeutic retrograde double-balloon enteroscopy,which occurred in an 85-year-old man who was treated for recurrent mid-intestinal bleeding that resulted from ileal angioectasia.This patient promptly underwent an operation and eventually recovered.展开更多
BACKGROUND Splenic injury following endoscopic retrograde cholangiopancreatography(ERCP)is a rare complication.The literature contains around 30 articles reporting various degrees of splenic injuries resulting from ER...BACKGROUND Splenic injury following endoscopic retrograde cholangiopancreatography(ERCP)is a rare complication.The literature contains around 30 articles reporting various degrees of splenic injuries resulting from ERCP since the first report of splenic rupture after ERCP in 1989.CASE SUMMARY This report describes a case of splenic hematoma and stent displacement in a 69-year-old male patient who developed these conditions 7 days after undergoing ERCP and stenting.The patient had bile duct stenosis caused by a malignant tumor that was obstructing the bile duct.The diagnosis was confirmed by epigastric computed tomography and magnetic resonance cholangiopancreatography.The patient was successfully treated with percutaneous transhepatic cholangial drainage,endoscopic pyloric stent placement,and conservative management.The causes of splenic injury following ERCP are discussed.CONCLUSION ERCP has the potential to cause splenic injury.If a patient experiences symptoms such as abdominal pain,decreased blood pressure,and altered hematology after the procedure,it's important to be thoroughly investigated for postoperative bleeding and splenic injury.展开更多
Objective To study the effects of hypotensive resuscitation and larger volume fluid resuscitation on uncontrolled hemorrhagic shock and survival in rats with a standardized massive splenic injury model（MSI）.Methods ...Objective To study the effects of hypotensive resuscitation and larger volume fluid resuscitation on uncontrolled hemorrhagic shock and survival in rats with a standardized massive splenic injury model（MSI）.Methods Following the MSI model,fifty Wistar rats were randomly and equally divided into five groups,group 1:sham-operated group,group 2: shock untreated group,group 3:normal MAP resuscitation group（during acute resuscitation phase MAP was kept at 80 mm Hg）,group 4:Hypotensive resuscitation group（during acute resuscitation phase MAP was kept at（60±5） mm Hg）,and group 5:larger volume fluid resuscitation with hypotensive resuscitation group(during acute resuscitation phase MAP was kept at（60±5） mm Hg,simultaneously infused SNP at 5 μg·kg-1·min-1).Results The mean survival time in group 1～5 was 180 min,73.50 min±8.04 min,114.30 min±31.33 min,146.70 min±28.07 min and 171.60 min±15.74 min respectively.Statistic significances were seen in each group（P<0.05）,except between group 1 and group 5（P=0.0671）.The amount of bleeding in group 2～5（during acute resuscitation phase） was 3.79 ml/kg±1.39 ml/kg、17.41 ml/kg±8.88 ml/kg、8.67 ml/kg±4.59 ml/kg and 10.33 ml/kg±4.31 ml/kg respectively.The loss of blood in group 3 was significantly more than other groups（P<0.05）.Group 4 and 5 enhanced the blood loss significantly compared with group 2（P<0.05）.The histopathologic of liver and renal showed that histopathologic injury is severe in group 3 compared with group 4,and histopathologic injury is not in evidence in group 5.Conclusion Hypotensive resuscitation and adding SNP at proper dose additionally could improve tissue metabolism and prolong survival time during hypotensive resuscitation from uncontrolled hemorrhagic shock.It is a more ideal resuscitation method compared with normal blood pressure resuscitation.展开更多
Background: Spleen injuries are most commonly associated with blunt abdominal trauma and represent a potentially life-threatening condition. Objectives: To study the pattern of splenic injuries of the patient, managem...Background: Spleen injuries are most commonly associated with blunt abdominal trauma and represent a potentially life-threatening condition. Objectives: To study the pattern of splenic injuries of the patient, management instituted and its outcome at Khartoum. Patients and Methods: This is a prospective, analytic and hospital-based multicenteric study, conducted at the three main Teaching hospitals at Khartoum. The study was carried over a period from April 2012 to February 2013. It includes all patients, diagnosed as traumatic splenic injury. Excluded were patients with history of splenic disease, iatrogenic injury or spontaneous rupture. Results: The study included 47 patients: their mean age was 26.4 years (SD ± 14.5). Most of them 41 (87.2%) were in the first four decades of life. Males were predominant 41 (87.2%), with a male to female ratio of 6.8:1. The majority of our patients had blunt abdominal trauma 39 (83%), of whom, road traffic accident accounted for 51.1% and none reported cases of gunshot. Isolated splenic injury was found in 23 (48.9%), and Haemodynamic stability was seen in 27 (57.4%) on presentation. The initial haemoglobin assessment revealed <9 gram/dl in 53.2%. CT scan was performed to 24 (51.1%), of whom 66 patients were Grade I and II and none of our patients were diagnosed as Grade V. Blood transfusion was required in 42 (89.4%). Operative treatment was adopted in 66% (61.7% total splenectomy and 4.3% splenorrhaphy), while selective non-operative management was successful in 16 (34%) of the patients. Higher intra-operative grade of splenic injury was found to be significantly associated with blunt abdominal trauma, haemodynamic instability and associated intra-abdominal injuries. 44 patients (93.6%) were discharged home in a general good condition. The morbidity and mortality were seen in 8.5% and 6.4% respectively. Conclusion: Splenic injuries usually follow blunt abdominal trauma, particularly after road traffic accidents. It is common during the first four decades of life with males 展开更多
基金Supported by Awarded the Second class Prize of National Science and Technology Advance in 2000(J-233-2-08).
文摘AIM: To evaluate the clinical application of serial operations with preservation of spleen. METHODS: Serial operations with preserving spleen were performed on 211 cases in our hospital from 1980 to 2000. The patient's age ranged from 13 to 56 years, averaging 38 years. Diseases included splenic injury in 171 cases, portal hypertension in 9 cases, splenic cyst in 10 cases, and the lesion of pancreatic body and tail in 21 cases. RESULTS: All the cases were cured, and 129 patients were followed up from 3 months to 3 years with the leukocyte phagocytosis test, detection of immunoglubin, CT,(99m)Tc scanning and ultrasonography. The results were satisfactory. CONCLUSION: The operations with preserving spleen were safe, feasible, and worth of clinical application.
文摘Splenic rupture is a rare complication of diagnostic and therapeutic gastrointestinal endoscopy procedures.Herein,we report for the first time a case of splenic rupture following therapeutic retrograde double-balloon enteroscopy,which occurred in an 85-year-old man who was treated for recurrent mid-intestinal bleeding that resulted from ileal angioectasia.This patient promptly underwent an operation and eventually recovered.
基金Natural Science Foundation of Inner Mongolia Autonomous Region,No.2024 LHMS08053.
文摘BACKGROUND Splenic injury following endoscopic retrograde cholangiopancreatography(ERCP)is a rare complication.The literature contains around 30 articles reporting various degrees of splenic injuries resulting from ERCP since the first report of splenic rupture after ERCP in 1989.CASE SUMMARY This report describes a case of splenic hematoma and stent displacement in a 69-year-old male patient who developed these conditions 7 days after undergoing ERCP and stenting.The patient had bile duct stenosis caused by a malignant tumor that was obstructing the bile duct.The diagnosis was confirmed by epigastric computed tomography and magnetic resonance cholangiopancreatography.The patient was successfully treated with percutaneous transhepatic cholangial drainage,endoscopic pyloric stent placement,and conservative management.The causes of splenic injury following ERCP are discussed.CONCLUSION ERCP has the potential to cause splenic injury.If a patient experiences symptoms such as abdominal pain,decreased blood pressure,and altered hematology after the procedure,it's important to be thoroughly investigated for postoperative bleeding and splenic injury.
文摘Objective To study the effects of hypotensive resuscitation and larger volume fluid resuscitation on uncontrolled hemorrhagic shock and survival in rats with a standardized massive splenic injury model（MSI）.Methods Following the MSI model,fifty Wistar rats were randomly and equally divided into five groups,group 1:sham-operated group,group 2: shock untreated group,group 3:normal MAP resuscitation group（during acute resuscitation phase MAP was kept at 80 mm Hg）,group 4:Hypotensive resuscitation group（during acute resuscitation phase MAP was kept at（60±5） mm Hg）,and group 5:larger volume fluid resuscitation with hypotensive resuscitation group(during acute resuscitation phase MAP was kept at（60±5） mm Hg,simultaneously infused SNP at 5 μg·kg-1·min-1).Results The mean survival time in group 1～5 was 180 min,73.50 min±8.04 min,114.30 min±31.33 min,146.70 min±28.07 min and 171.60 min±15.74 min respectively.Statistic significances were seen in each group（P<0.05）,except between group 1 and group 5（P=0.0671）.The amount of bleeding in group 2～5（during acute resuscitation phase） was 3.79 ml/kg±1.39 ml/kg、17.41 ml/kg±8.88 ml/kg、8.67 ml/kg±4.59 ml/kg and 10.33 ml/kg±4.31 ml/kg respectively.The loss of blood in group 3 was significantly more than other groups（P<0.05）.Group 4 and 5 enhanced the blood loss significantly compared with group 2（P<0.05）.The histopathologic of liver and renal showed that histopathologic injury is severe in group 3 compared with group 4,and histopathologic injury is not in evidence in group 5.Conclusion Hypotensive resuscitation and adding SNP at proper dose additionally could improve tissue metabolism and prolong survival time during hypotensive resuscitation from uncontrolled hemorrhagic shock.It is a more ideal resuscitation method compared with normal blood pressure resuscitation.
文摘Background: Spleen injuries are most commonly associated with blunt abdominal trauma and represent a potentially life-threatening condition. Objectives: To study the pattern of splenic injuries of the patient, management instituted and its outcome at Khartoum. Patients and Methods: This is a prospective, analytic and hospital-based multicenteric study, conducted at the three main Teaching hospitals at Khartoum. The study was carried over a period from April 2012 to February 2013. It includes all patients, diagnosed as traumatic splenic injury. Excluded were patients with history of splenic disease, iatrogenic injury or spontaneous rupture. Results: The study included 47 patients: their mean age was 26.4 years (SD ± 14.5). Most of them 41 (87.2%) were in the first four decades of life. Males were predominant 41 (87.2%), with a male to female ratio of 6.8:1. The majority of our patients had blunt abdominal trauma 39 (83%), of whom, road traffic accident accounted for 51.1% and none reported cases of gunshot. Isolated splenic injury was found in 23 (48.9%), and Haemodynamic stability was seen in 27 (57.4%) on presentation. The initial haemoglobin assessment revealed <9 gram/dl in 53.2%. CT scan was performed to 24 (51.1%), of whom 66 patients were Grade I and II and none of our patients were diagnosed as Grade V. Blood transfusion was required in 42 (89.4%). Operative treatment was adopted in 66% (61.7% total splenectomy and 4.3% splenorrhaphy), while selective non-operative management was successful in 16 (34%) of the patients. Higher intra-operative grade of splenic injury was found to be significantly associated with blunt abdominal trauma, haemodynamic instability and associated intra-abdominal injuries. 44 patients (93.6%) were discharged home in a general good condition. The morbidity and mortality were seen in 8.5% and 6.4% respectively. Conclusion: Splenic injuries usually follow blunt abdominal trauma, particularly after road traffic accidents. It is common during the first four decades of life with males
