Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma

Iosvany Rivero Hernández; Antonio Calvo Durán; Ana Diez Núñez; Juan Alija Castro; Vicente Vega Ruiz

doi:doi:10.11648/j.ass.20210901.12

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Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma

Iosvany Rivero Hernández, Antonio Calvo Durán, Ana Diez Núñez, Juan Alija Castro, Vicente Vega Ruiz

Published in Advances in Surgical Sciences (Volume 9, Issue 1)

Received: 29 January 2021 Accepted: 6 February 2021 Published: 23 February 2021

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Abstract

Massive splenic infarction is an uncommon diagnosis that is often overlooked. It is whether asymptomatic or symptomatic with abdominal pain, fever and splenomegaly. There is no consensus on which the best treatment option is, in most cases it is about deciding on conservative or surgical management according to individual patient characteristics. Case presentation: We present the case of a 33- year- old patient with a blunt abdominal trauma while riding a horse, who is taken to the hospital emergency department. A contrast-enhanced abdominal computed tomography is carried out with the diagnosis of a Grade III pancreatic lesion involving the distal portion of the body and tail of the pancreas with associated active bleeding. An urgent laparotomy is performed with a spleen-preserving distal pancreatectomy procedure. During the immediate postoperative phase a massive splenic infarction is diagnosed after a follow-up contrast-enhanced abdominal computed tomography is carried out and successfully treated with conservative measures. Conclusions: It is important to highlight the feasibility of the non-surgical treatment in this kind of spleen lesion, because the spleen preservation proves to be necessary, whenever possible, due to the importance of its immunological role for the high risk of sepsis associated with death and neoplastic processes on those individuals with splenectomy.

Published in	Advances in Surgical Sciences (Volume 9, Issue 1)
DOI	10.11648/j.ass.20210901.12
Page(s)	6-9
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Massive Splenic Infarct, Distal Pancreatectomy, Blunt Abdominal Trauma

References

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[2]	Kranidiotis G, Efstratiadis E, Kapsalakis G, Loizos G, et al. Splenic infarcts as a rare manifestation of parvovirus B19 infection. IDCases. 2016; 4: 62-4.
[3]	Bokman Christine L.; Sfeir Maroun; Chahwala Veer; Ginzburg Enrique. Spontaneous massive splenic infarction in the setting of renal transplant and septic shock: a case report and review of the literature. Case Rep Med. 2014.
[4]	Arenal Vera, J. J. et al. Splenic infarction secondary to acute pancreatitis. Rev. Esp. Enferm. Dig. 2008; 100 (5): 300-303.
[5]	Y.-S. Yoon, K. H. Lee, H.-S. Han, J. Y. Cho and K. S. Ahn. Patency of splenic vessels after laparoscopic spleen and splenic vessel-preserving distal pancreatectomy. British Journal of Surgery 2009; 96: 633–640.
[6]	Sun et al. Clinical efficacy of spleen-preserving distal pancreatectomy with or without splenic vessel preservation. A Meta-analysis. Medicine (2017) 96: 48.
[7]	Antopolsky M, Hiller N, Salameh S, Goldshtein B, et al. Splenic infarction: 10 years of experience. Am J Emerg Med. 2009; 27 (3): 262-5.
[8]	F. Fatjó, J. Ramos, A. Culla y J. M. Grau. Splenic infarctions: an uncommon cause of febril syndrome. Med Clin (Barc) 2002; 119 (9): 356-9.
[9]	D’Angelo G, Marseglia L, Russo T, Gitto E, et al. Long term follow up of a massive, conservatively treated, splenic infarction in a young adolescent. Pediatr Int. 2017; 59 (11): 1210-2.
[10]	Lamsfus-Prieto JA et al. Prevention of sepsis in asplenic patients. Cir Esp. 2007; 81 (5): 247-51.
[11]	Skandalakis JE, Colborn GL, Pemberton LB, Skandalakis TN, Skandalakis LJ, Gray SW. The surgical anatomy of the spleen. Prob Gen Surg 7 (1): 1-17, 1990.
[12]	Carrére et al.: Spleen-preserving distal pancreatectomy with excision of splenic artery and vein: A case matched comparison with conventional distal pancreatectomy with splenectomy. World J Surg (2007) 31: 375–382.
[13]	A. L. Warshaw, “Conservation of the spleen with distal pancreatectomy,” JAMA Surgery, vol. 123, no. 5, pp. 550–553, 1988.
[14]	Ferrone et al, “Twenty-Three Years of the Warshaw Operation for Distal Pancreatectomy With Preservation of the Spleen”. Ann Surg 2011; 253: 1136–1139.
[15]	Kimura et al, “A case of complete splenic infarction after laparoscopic spleen-preserving distal pancreatectomy. BMC Surgery (2018) 18: 22.

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APA Style

Iosvany Rivero Hernández, Antonio Calvo Durán, Ana Diez Núñez, Juan Alija Castro, Vicente Vega Ruiz. (2021). Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma. Advances in Surgical Sciences, 9(1), 6-9. https://doi.org/10.11648/j.ass.20210901.12

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ACS Style

Iosvany Rivero Hernández; Antonio Calvo Durán; Ana Diez Núñez; Juan Alija Castro; Vicente Vega Ruiz. Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma. Adv. Surg. Sci. 2021, 9(1), 6-9. doi: 10.11648/j.ass.20210901.12

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AMA Style

Iosvany Rivero Hernández, Antonio Calvo Durán, Ana Diez Núñez, Juan Alija Castro, Vicente Vega Ruiz. Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma. Adv Surg Sci. 2021;9(1):6-9. doi: 10.11648/j.ass.20210901.12

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@article{10.11648/j.ass.20210901.12,
  author = {Iosvany Rivero Hernández and Antonio Calvo Durán and Ana Diez Núñez and Juan Alija Castro and Vicente Vega Ruiz},
  title = {Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma},
  journal = {Advances in Surgical Sciences},
  volume = {9},
  number = {1},
  pages = {6-9},
  doi = {10.11648/j.ass.20210901.12},
  url = {https://doi.org/10.11648/j.ass.20210901.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20210901.12},
  abstract = {Massive splenic infarction is an uncommon diagnosis that is often overlooked. It is whether asymptomatic or symptomatic with abdominal pain, fever and splenomegaly. There is no consensus on which the best treatment option is, in most cases it is about deciding on conservative or surgical management according to individual patient characteristics. Case presentation: We present the case of a 33- year- old patient with a blunt abdominal trauma while riding a horse, who is taken to the hospital emergency department. A contrast-enhanced abdominal computed tomography is carried out with the diagnosis of a Grade III pancreatic lesion involving the distal portion of the body and tail of the pancreas with associated active bleeding. An urgent laparotomy is performed with a spleen-preserving distal pancreatectomy procedure. During the immediate postoperative phase a massive splenic infarction is diagnosed after a follow-up contrast-enhanced abdominal computed tomography is carried out and successfully treated with conservative measures. Conclusions: It is important to highlight the feasibility of the non-surgical treatment in this kind of spleen lesion, because the spleen preservation proves to be necessary, whenever possible, due to the importance of its immunological role for the high risk of sepsis associated with death and neoplastic processes on those individuals with splenectomy.},
 year = {2021}
}

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TY  - JOUR
T1  - Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma
AU  - Iosvany Rivero Hernández
AU  - Antonio Calvo Durán
AU  - Ana Diez Núñez
AU  - Juan Alija Castro
AU  - Vicente Vega Ruiz
Y1  - 2021/02/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ass.20210901.12
DO  - 10.11648/j.ass.20210901.12
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 6
EP  - 9
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20210901.12
AB  - Massive splenic infarction is an uncommon diagnosis that is often overlooked. It is whether asymptomatic or symptomatic with abdominal pain, fever and splenomegaly. There is no consensus on which the best treatment option is, in most cases it is about deciding on conservative or surgical management according to individual patient characteristics. Case presentation: We present the case of a 33- year- old patient with a blunt abdominal trauma while riding a horse, who is taken to the hospital emergency department. A contrast-enhanced abdominal computed tomography is carried out with the diagnosis of a Grade III pancreatic lesion involving the distal portion of the body and tail of the pancreas with associated active bleeding. An urgent laparotomy is performed with a spleen-preserving distal pancreatectomy procedure. During the immediate postoperative phase a massive splenic infarction is diagnosed after a follow-up contrast-enhanced abdominal computed tomography is carried out and successfully treated with conservative measures. Conclusions: It is important to highlight the feasibility of the non-surgical treatment in this kind of spleen lesion, because the spleen preservation proves to be necessary, whenever possible, due to the importance of its immunological role for the high risk of sepsis associated with death and neoplastic processes on those individuals with splenectomy.
VL  - 9
IS  - 1
ER  -

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Author Information

Iosvany Rivero Hernández

Department of General and Digestive Surgery, Universitary Hospital of Puerto Real, Puerto Real, Spain
Antonio Calvo Durán

Department of General and Digestive Surgery, Universitary Hospital of Puerto Real, Puerto Real, Spain
Ana Diez Núñez
Juan Alija Castro

Department of Radiology, Universitary Hospital of Puerto Real, Puerto Real, Spain
Vicente Vega Ruiz

Department of General and Digestive Surgery, Universitary Hospital of Puerto Real, Puerto Real, Spain

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APA Style

Iosvany Rivero Hernández, Antonio Calvo Durán, Ana Diez Núñez, Juan Alija Castro, Vicente Vega Ruiz. (2021). Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma. Advances in Surgical Sciences, 9(1), 6-9. https://doi.org/10.11648/j.ass.20210901.12

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ACS Style

Iosvany Rivero Hernández; Antonio Calvo Durán; Ana Diez Núñez; Juan Alija Castro; Vicente Vega Ruiz. Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma. Adv. Surg. Sci. 2021, 9(1), 6-9. doi: 10.11648/j.ass.20210901.12

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AMA Style

Iosvany Rivero Hernández, Antonio Calvo Durán, Ana Diez Núñez, Juan Alija Castro, Vicente Vega Ruiz. Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma. Adv Surg Sci. 2021;9(1):6-9. doi: 10.11648/j.ass.20210901.12

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@article{10.11648/j.ass.20210901.12,
  author = {Iosvany Rivero Hernández and Antonio Calvo Durán and Ana Diez Núñez and Juan Alija Castro and Vicente Vega Ruiz},
  title = {Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma},
  journal = {Advances in Surgical Sciences},
  volume = {9},
  number = {1},
  pages = {6-9},
  doi = {10.11648/j.ass.20210901.12},
  url = {https://doi.org/10.11648/j.ass.20210901.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20210901.12},
  abstract = {Massive splenic infarction is an uncommon diagnosis that is often overlooked. It is whether asymptomatic or symptomatic with abdominal pain, fever and splenomegaly. There is no consensus on which the best treatment option is, in most cases it is about deciding on conservative or surgical management according to individual patient characteristics. Case presentation: We present the case of a 33- year- old patient with a blunt abdominal trauma while riding a horse, who is taken to the hospital emergency department. A contrast-enhanced abdominal computed tomography is carried out with the diagnosis of a Grade III pancreatic lesion involving the distal portion of the body and tail of the pancreas with associated active bleeding. An urgent laparotomy is performed with a spleen-preserving distal pancreatectomy procedure. During the immediate postoperative phase a massive splenic infarction is diagnosed after a follow-up contrast-enhanced abdominal computed tomography is carried out and successfully treated with conservative measures. Conclusions: It is important to highlight the feasibility of the non-surgical treatment in this kind of spleen lesion, because the spleen preservation proves to be necessary, whenever possible, due to the importance of its immunological role for the high risk of sepsis associated with death and neoplastic processes on those individuals with splenectomy.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Massive Splenic Infarction Secondary to Distal Pancreatectomy for a Blunt Abdominal Trauma
AU  - Iosvany Rivero Hernández
AU  - Antonio Calvo Durán
AU  - Ana Diez Núñez
AU  - Juan Alija Castro
AU  - Vicente Vega Ruiz
Y1  - 2021/02/23
PY  - 2021
N1  - https://doi.org/10.11648/j.ass.20210901.12
DO  - 10.11648/j.ass.20210901.12
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 6
EP  - 9
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20210901.12
AB  - Massive splenic infarction is an uncommon diagnosis that is often overlooked. It is whether asymptomatic or symptomatic with abdominal pain, fever and splenomegaly. There is no consensus on which the best treatment option is, in most cases it is about deciding on conservative or surgical management according to individual patient characteristics. Case presentation: We present the case of a 33- year- old patient with a blunt abdominal trauma while riding a horse, who is taken to the hospital emergency department. A contrast-enhanced abdominal computed tomography is carried out with the diagnosis of a Grade III pancreatic lesion involving the distal portion of the body and tail of the pancreas with associated active bleeding. An urgent laparotomy is performed with a spleen-preserving distal pancreatectomy procedure. During the immediate postoperative phase a massive splenic infarction is diagnosed after a follow-up contrast-enhanced abdominal computed tomography is carried out and successfully treated with conservative measures. Conclusions: It is important to highlight the feasibility of the non-surgical treatment in this kind of spleen lesion, because the spleen preservation proves to be necessary, whenever possible, due to the importance of its immunological role for the high risk of sepsis associated with death and neoplastic processes on those individuals with splenectomy.
VL  - 9
IS  - 1
ER  -

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