Showing 2 Abstracts.
Introduction: Accessory spleen is an abnormality represented by ectopic splenic tissue detached from the main body of the spleen. Torsion is a possible complication and it occurs exceptionally. Clinically it is characterized by a nonspecific acute or recurrent abdominal pain. Case: A 12 years old female with recurrent abdominal pain and palpable mass on her left iliac fossa, that has been noticed a month before consultation. At the emergency service she was checked and complementary exams were requested. US: In the left iliac fossa it was found a solid, rounded formation, with well-defined edges, which moved when the patient changed her position. It showed positive Doppler examination except for a focal hypoechogenic area, which was not vascularized. The structure reminded the spleen echogenicity. CT: normal spleen parenchyma, shape and edges. At left iliac fossa, next to the lower pole of the kidney, a rounded well-defined image which showed heterogeneous EV enhancement with no opacification of the lower corner due to ischemia areas was seen. This image had a vascular hilum that connected to the main spleen vascular hilum. Further images where taken changing the patient position, where the movement of the mass was corroborated. As a result of this exams we realized that the recurrent abdominal pain of the girl was due to an ectopic spleen that has been torsioned - detorsioned several times. Conclusions: Usually, accessory spleen is asymptomatic. Torsion and infarction, rupture with bleeding, and infection with abscess are a very rare complications. Intermittent torsion-detorsion may produce recurrent episodes of abdominal pain caused by short-lasting ischemia of the accessory spleen or from direct mechanical irritation of surrounding organs. To sum up, torsion of an accessory spleen is extremely rare and is still a diagnostic dilemma. So we should consider this any time a patient with abdominal pain (acute or recurrent) comes to us and other diagnosis failed to explain it. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Gonzalez Veronica, Aupy Ariane, Lulkin Solange
We report a case of 2-year-old female, twin, low birth weight (37 weeks, 1630 g - 3.59 lb), who was referred to our hospital to study an indurated nodular tumor involving her left leg, which extended from her pelvis to her left foot. Blood tests showed only an increase in alkaline phosphatase (862 mg/dl). Lower-limb X-ray was performed, which showed an extensive calcified mass with fibrillar pattern affecting dermis and deep connective tissue. MRI was also performed and showed an extensive signal alteration in muscle and dermis with hipointense signal in relation to heterotopic calcifications. The differential diagnoses were Albright hereditary osteodystrophy (AHO), fibrodysplasia ossificans progressiva (FOP), and progressive osseous heteroplasia (POH). AHO was ruled out because of the lack of compromise of muscle plane, and the absence of congenital malformations (such as brachydactyly, obesity, low height), hypocalcemia and hyperphosphatemia. Similarly, FOP was also ruled out since it is characterized by muscle ossification, with no dermal calcifications, and hallux malformation (also absent in this case). The diagnosis reached was POH, which is a rare genetic (autosomal dominant inheritance) disorder characterized by progressive periarticular ossification of dermis and deep connective tissues (muscles, tendons and ligaments), with no congenital malformations. The diagnosis is built upon the clinical symptoms, imaging findings and genetic study (GNAS mutation). There is no effective treatment, with frequent progression to ankylosis. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Funes Poblete Flavia, Mackintosh Cecilia, Vargas Maria, Gonzalez Veronica
Keywords: heteroplasia, dermal calcification, calcified mass