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
The lower GI study with water soluble contrast, is used to evaluate the remnant colon. The population to study includes patient with anorectal malformation, stenosis due to necrotizing enterocolitis, bowel resections or to plan the ostomy closure. There are scarce adverse effects reported in the literature. Case: We present a 7-month-old boy with operated cardiopathy and the prior story of necrotizing enterocolitis with bowel perforation a few days after the birth, with surgical intervention resolution. By the time of the study, our patient had ileostomy and colostomy in plan of reconnection, for that reason, the GI study was planned. The patient was lying down face up in the table. Plane X Ray of the abdomen was taken as a first move of the examination (normal air distribution, no abnormal radiopacities). Then a probe with a balloon was introduced in to the distal ostomy and the balloon was inflated with 5 ml of air to prevent the loose of the probe. A syringe of 20 ml was connected, and the solution was injected (1/3 ml Triyosom GI* and 2/3 ml water) with a moderated hydrostatic pressure. During the injection fluoroscopy was given and images of the distal colon were seen. No fistulas or loose of contrast was evidenced, neither contrast out of anus was seen, as a result of stenosis in that point. We emptied the distal colon by taking out the contrast. 3 hours after the practice the patient started vomiting, abdominal distention and signs of sepsis. He was admitted at the emergency. Finally, he died 6 hours after the GI study had been performed. Analytic results of the blood: 2/2 positive to Gram Negative. Autopsy informed: no GI signs of bacterial translocation. *Meglumina diatrizoato-diatrizoico acido. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Lulkin Solange, Sancho Cano Julieta, Lipsich Jose
Keywords: Lower GI study, children, Adverse Effects