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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Torsion of a spleen is a frequent complication of a rare entity--a wandering spleen. A wandering spleen is revealed occasionally, with physical and/or sonographic exam. However, it is often overseen. It has very unspecific simptoms, and can present a diagnostic problem. Splenic torsion manifets itself like an acute abdomen. We have presented a rare case of splenic torsion with unusual clinical findings, followed by a splenic infarction. Due to their promptness, sensitivity, uniqueness and availability, two diagnostic methods have definitive primacy in visualisation of splenic torsion: Color-Doppler sonography and CT with intravenous application of contrast medium.
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PMID:[Diagnostic methods in torsion of the spleen]. 1693 42

Wandering spleen is a rare medical entity. It usually occurs at 20-40 years of age, and most cases are seen in women. Clinical diagnosis is difficult due to lack of symptoms, unless splenic torsion has occurred and clinical symptomatology of acute abdomen develops. The diagnosis can be confirmed by imaging techniques. Treatment is operative due to complications of splenic infarction. Splenopexy is the usual treatment, except for cases of splenic infarction. Splenectomy should be carried out when there is no evidence of splenic blood flow after detorsion of the spleen and in cases of excessive splenomegaly.
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PMID:Wandering spleen with torsion of the pedicle. 1720 7

We report a case of acute liver ischemia resulting in liver failure that occurred due to celiac trunk occlusion by an aortic dissection. A 53-year-old patient presented with clinical signs of acute abdomen. He underwent an urgent laparotomy, which revealed a splenic infarction and thrombosis of the celiac artery all the way to the porta hepatis. Imaging showed that an acute thoracoabdominal aortic dissection was present, resulting in compression of the celiac trunk. The aorta was repaired with an intervascular graft; however, an acute insufficiency of the liver ensued, and the patient was urgently transplanted. To the best of our knowledge, this is the first report of vascular compromise of the liver due to acute aortic dissection that would require liver transplantation.
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PMID:Orthotopic liver transplantation in a patient with acute liver failure resulting from aortic dissection. 1808 31

Wandering spleen or splenoptosis is an uncommon entity and often an asymptomatic finding of acute abdomen in the emergency department. A high index of suspicion for splenic torsion is required, particularly in patients with known splenomegaly, as this condition could potentially lead to splenic infarction. Recognition of this condition can help avoid potential confusion with acute abdomen of other aetiologies. Herein, we present a unique case of wandering spleen with chronic torsion, which, to the best of our knowledge, has never been described in an elderly patient with haemoglobin H thalassaemia. We also review the literature for the aetiology and pathogenesis of wandering spleen, and discuss the relevant diagnostic modalities and treatment options.
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PMID:Wandering spleen with chronic torsion in a patient with thalassaemia. 2563 Mar 26

Wandering spleen is an uncommon entity in adults and has been described only rarely with sigmoid volvulus, that rarely affects children and adolescents. It is usually described in adults.Wandering spleen characterized by the abnormal location of the spleen, caused by incomplete fusion of the four primary splenic ligaments, allowing the spleen to be mobile within the abdomen.The wandering spleen can lead to torsion and subsequent splenic infarction or rupture. Clinical suspicion plus urgent investigation and intervention are important. We present a rare clinical case of acute abdomen due to torsion of wandering spleen and volvulus of sigmoid in a 14-year-old girl presented with painful periumbilical mass. Detorsion of sigmoid occurred while undergoing exploratory laparotomy and splenectomy was performed. The possibility of torsion and its complication like gastric, pancreas tail and colon volvulus should be kept in mind in the differential diagnosis of the acute abdomen to avoid serious complications.
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PMID:A Rare Case of Splenic Torsion with Sigmoid Volvulus in a 14-Year-Old Girl. 2685 94

Splenic infarction is a rare clinical condition seen in the emergency department and can mimic acute abdomen. Hematologic, vascular, and thromboembolic events are considered in the etiology. Treatment options vary between symptomatic treatment and splenectomy. Warfarin is a vitamin K antagonist used for the prevention and treatment of thromboembolic disorders. In overdose situations, there is a possibility of bleeding in every part of the body. Prothrombin complex concentrates, vitamin K, and fresh-frozen plasma are used in the treatment of warfarin overdose. We describe a case of splenic infarction coexistent with warfarin overdose treatment, which has never been published in literature. Prothrombin complex concentrate was administered to the patient because of warfarin overdose. A spleen infarction was detected in computerized tomography of the patient after the occurrence of abdominal pain, and there was no infarction three days before hospitalization. The patient was monitored with symptomatic treatment in the general surgery clinic and discharged without the need for operation. In the pathogenesis, it was thought that prothrombin complex concentrates might be caused by early thrombosis or by warfarin not affecting the existing clot. Emergency physicians should not forget spleen infarction in the differential diagnosis of abdominal pain.
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PMID:Splenic Infarction after Warfarin Overdose Treatment: Is It a Coincidence or Complication? 3100 21


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