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Complications of open repair of splanchnic aneurysms
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Bjoern D. Suckow, David H. Stone
Splenic artery aneurysms are usually asymptomatic. Symptoms, when present, often include vague epigastric pain, left upper quadrant pain, or back pain. Hemodynamic demise or frank shock may occur in the setting of free rupture. At times, initial bleeding from a ruptured splenic aneurysm may be contained in the lesser sac leading to transiently stable hemodynamics. Alternatively, the patient may become subsequently unstable when free rupture consequently transpires via extravasation of blood from the lesser sac via the foramen of Winslow or the pars flacida of the gastrohepatic omentum.6
Abdominal trauma
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Steven Stylianos, Mark V. Mazziotti
Even the most severe solid organ injuries can be treated without surgery if there is prompt response to resuscitation. In contrast, emergency laparotomy and/or embolization are indicated in patients who are hemodynamically unstable, despite fluid and red blood cell transfusion (Figure 84.5). Fenton et al. evaluated 605 patients with abdominal solid organ injury and found that 18 (3%) had angiography. Embolization of the splenic artery was performed in 11 of 18 patients. Most spleen and liver injuries requiring operation are amenable to simple methods of hemostasis using a combination of manual compression, direct suture, topical hemostatic agents, and woven polyglycolic mesh wrapping (Figure 84.6a and b).
The immune and lymphatic systems, infection and sepsis
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Michelle Treacy, Caroline Smales, Helen Dutton
The spleen is located just under the diaphragm in the upper left quadrant of the abdominal cavity, curving around the anterior aspect of the stomach; it is supplied by the splenic artery which enters at the hilus. The main functions of the largest lymphoid organ are: Surveillance for infection;Lymphocyte propagation;Filtering and cleaning of the blood from blood-borne pathogens and toxins;Storage of platelets and removal of ageing, faulty platelets and red blood cells and the extraction and storage of iron for the production of haemoglobin.
Review spontaneous superior mesenteric artery aneurysm rupture following caesarean section: an uncommon event and review of current literature
Published in Journal of Obstetrics and Gynaecology, 2022
Mustafa Sengul, Halime Sen Selim
A literature search was performed on the current literature regarding aneurysms in pregnancy. The incidence of SMA aneurysms or related conditions of this artery location such as dissection is not well described, and there have been no case reports of this specific situation to our knowledge, thus to comment about a given population’s risk of developing aneurysms and ruptures of such is limited. We have searched on PUBMED ‘Superior mesenteric artery rupture and pregnancy’ only 6 results have found but they haven’t included SMA rupture case; ‘Sma rupture and postpartum period’ 2 results were returned which one of this about middle colic artery and the other one is ‘internal Pudendal artery’. Also, we look at up-to-date data about visceral artery aneurysm, only two sources about this issue, both of them related to the splenic artery.
Surgical Management of Life Threatening Bleeding after Endoscopic Cystogastrostomy
Published in Journal of Investigative Surgery, 2018
Ashish George, Rajesh Panwar, Sujoy Pal
The abdomen was explored through an upper midline laparotomy. There was no blood in the peritoneal cavity. The gastrocolic ligament was thickened and there was no avascular plane between stomach and transverse colon. The stomach was pushed anteriorly by the large lesser sac collection. A 6–7 cm anterior gastrotomy was done after taking stay sutures (Figure 2a). The stent was visible after the anterior gastrotomy and there was a bulge in the posterior wall of stomach (Figure 2b). The lesser sac collection was entered through the posterior wall of stomach and a 6 cm cystogastrostomy was done using a 75 mm stapler (Figure 2c). The pseudocyst was filled with around 600 ml of blood clots and there was fresh blood as well. The cyst cavity was quickly evacuated after which the active spurt from the splenic artery was seen. The bleeding was first temporarily controlled using digital pressure. The splenic artery was then ligated in continuity just proximal and distal to the site of bleeding and hemostasis was secured (Figure 2d). The anterior gastrotomy was then repaired in two layers.
Pharmacotherapeutic advances for splenomegaly in myelofibrosis
Published in Expert Opinion on Pharmacotherapy, 2023
Douglas Tremblay, John Mascarenhas
Understanding the causes of splenomegaly in MF first necessitates a discussion of the splenic anatomy. The spleen is divided into the white pulp, which serves as a reservoir for lymphocytes, and the red pulp, which functions to filter blood [12]. The spleen itself is encapsulated in dense, irregular fibrous tissue. Blood flows into the spleen through the splenic artery which branches into arterioles. From there, approximately 90% goes through the venous sinuses while 10% filters through the red pulp [13]. Splenomegaly in MF is primarily a consequence of extramedullary hematopoiesis from abnormal hematopoietic stem cell (HSC) trafficking to the red pulp of the spleen, and there are multiple molecular mechanisms which contribute to extramedullary hematopoiesis in MF patients.