Search Results (4)

Background/Objectives: Splenic torsion is a well-known and reported clinical problem. Splenic torsions after abdominal trauma represent a small group of cases that involve surgical management. They manifest primarily as abdominal pain, and the diagnosis is made based on imaging studies—ultrasound, CT, and MRI. Methods: This work aimed to analyze traumatic splenic torsions in terms of their clinical course, symptoms, timing, involvement of imaging techniques in the diagnosis, histopathological examination, and overall outcome. We searched databases using the desk research method under the keywords “splenic torsion”, “torsion”, and “spleen”, as well as in combination with “traumatic”, finding a total of eight cases, which we included in our analysis. Results: The eight cases were analyzed, comprising four females and four males, with an average age of 16.25 years (range 5–29 years). Traffic accidents were the most frequent cause of injury (five cases), while the circumstances were unclear in the remaining three. Immediate abdominal symptoms appeared in six patients. Splenic torsion was preoperatively diagnosed in five out of seven confirmed cases. A total of seven patients underwent laparotomy with splenectomy. In one case, laparoscopy converted to laparotomy with splenopexy preserved the spleen. Histopathology, performed in only two cases, confirmed splenic infarction in one patient; infarction status could not be determined in the remaining five due to missing data. Conclusions: Post-traumatic splenic torsions are a group of atypical injuries as the primary and immediate consequence of the trauma suffered is not anatomical–structural damage to the organ, such as a rupture. Mostly affecting young people, the cases described in the professional literature involve the main spleen, which was considered to be “wandering”, suggesting that this is a key predisposing factor for splenic torsion following blunt trauma and requiring diagnostic imaging for diagnosis. Full article

Background: A wandering accessory spleen (WAS) is defined as an ectopic accessory spleen with a long vascular pedicle characterized by marked anatomical mobility. “Wandering” can be congenital or acquired due to splenomegaly or pregnancy. The study aimed to analyze the clinical course of WAS and its symptoms. Methods: The desk research method and statistical analysis were used to assess the outcome. Results: In total, 12 cases of WAS managed operatively, including 11 women and 1 man, have been found. The correct WAS diagnosis was established before surgery in 3 of the 12 patients. One individual did not exhibit any symptoms and underwent surgery to avoid WAS torsion and infarction. Abdominal pain was the most commonly reported symptom in 11 patients. No mortality has been reported. Conclusions: WAS is a rare anomaly. It can be symptomatic or produce a spectrum of symptoms, such as abdominal pain, and may resemble abdominal neoplasms. Torsion is the most common pathology in the WAS study group and is most common in young people. Full article

Background: As a ubiquitous apicomplexan parasite, Toxoplasma gondii causes huge economic losses and poses a great threat to the health of animals, including humans, worldwide. In some kangaroo species, T. gondii can be fatal. To date, little information is available on T. gondii infection in the red kangaroos in east China. At a zoo in east China, thirteen red kangaroos consecutively developed clinical signs from July to November 2016, resulting in the deaths of seven, three of which were analyzed in this study. Methods: In the present study, ascitic fluid, blood and samples from the brain, heart, liver, spleen, lung, kidney, and mesenteric lymph nodes of three dead red kangaroos were collected. The pathogen was explored through microscopic observation, nested PCR, immunofluorescence antibody test (IFAT), hematoxylin–eosin (HE) staining, and immunohistochemistry (IHC) staining, respectively. Meanwhile, the potential source of the infection was also investigated by testing the blood of stray cats in the zoo for T. gondii using nested PCR. Results: Three dead red kangaroos were subjected to a necropsy, and organisms resembling T. gondii were detected in their ascitic fluids under microscope. This infection was further confirmed by a nested PCR assay, which resulted in a successful amplification and sequencing of the 433 bp fragment of the T. gondii 5.8S rRNA gene in all the dissected tissues, including heart, liver, spleen, lung, kidney, lymph nodes, cecum, and brain, as well as in body fluids (blood and ascitic fluid). Furthermore, the tachyzoites were observed in the heart, liver, spleen, lymph nodes, cecum, and brain through IFAT and HE staining. Administration of classic drugs (sulfadiazine and pyrimethamine) against T. gondii significantly alleviated the clinical signs of the sick kangaroos. The possible source of this infection was traced to a native stray cat, as T. gondii DNA was detected in its blood. Conclusions: In the present study, lethal T. gondii infection in red kangaroos has been described for the first time in east China, highlighting the necessity and urgency for close and long-term surveillance of this parasite infection in captive animals. The same strain of T. gondii detected in kangaroos as that found in stray cats wandering in the same area emphasizes the importance of controlling stray cat populations to mitigate the risk of Toxoplasma transmission to other animals. Full article

Wandering spleen (WS) is a rare condition often linked with torsion or infarction, but its association with Bochdalek hernia, acute appendicitis, and thrombocytopenia is exceptionally rare. We present a case of a nine-year-old girl who was admitted with acute abdominal pain, later diagnosed with WS, Bochdalek hernia, and acute appendicitis. A literature search was performed on PubMed and Google Scholar on 30 May 2024 with keywords including “Wandering spleen” and (“Bochdalek Hernia” OR “Sepsis” OR “Acute Appendicitis” OR “Thrombocytopenia”). The management was complicated by severe thrombocytopenia and post-operative sepsis, with Klebsiella pneumoniae as the causative agent. Imaging revealed an abnormally located spleen and significant splenic enlargement over time. The patient’s condition was managed non-operatively concerning the WS, avoiding splenectomy due to the risks of post-splenectomy sepsis. Instead, laparotomy was performed to address the appendicitis and diaphragmatic hernia. The patient experienced post-operative complications, including a seizure and persistent fever, which resolved with appropriate antibiotic therapy. This case underscores the complexity of managing WS with concurrent severe conditions, highlighting the importance of individualised treatment strategies. It also emphasises the need for further studies to explore optimal treatment modalities for such rare and complex presentations. This case serves as an educational example in clinical settings, demonstrating the challenges and considerations when treating multiple rare pathologies simultaneously. Full article