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Rastogi V, Singh D, Tekiner H, Ye F, Mazza JJ, Yale SH. Abdominal Physical Signs of Inspection and Medical Eponyms. Clin Med Res 2019; 17:115-126. [PMID: 31308022 PMCID: PMC6886890 DOI: 10.3121/cmr.2019.1420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 03/11/2019] [Accepted: 03/18/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND An eponym in clinical medicine is an honorific term ascribed to a person(s) who may have initially discovered or described a device, procedure, anatomical part, treatment, disease, symptom, syndrome, or sign found on physical examination. Signs, although often lacking sufficient sensitivity and specificity, assist in some cases to differentiate and diagnose disease. With the advent of advanced technological tools in radiological imaging and diagnostic testing, the importance of inspection, the initial steps taught during the physical examination, is often overlooked or given only cursory attention. Nevertheless, in the era of evidence-based and cost-effective medicine, it becomes compelling, and we contend that a meticulously performed history and physical examination, applying the basic tenets of inspection, remains paramount prior to obtaining appropriate diagnostic tests. DATA SOURCES PubMed, Medline, online Internet word searches and bibliographies from source text and textbooks. PubMed was searched using the Medical Subject Heading (MeSH) of the name of the eponyms and text words associated with the sign. CONCLUSIONS We describe the historical aspect, clinical application, and performance of medical eponymous signs of inspection found on physical examination during the 18th to 20th centuries.
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Affiliation(s)
- Vaibhav Rastogi
- University of Central Florida College of Medicine, Graduate Medical Education, 6850 Lake Nona Blvd, Orlando, Florida
| | - Devina Singh
- University of Florida, Department of Medicine. 2000 SW Archer Rd, Gainesville, Florida
| | - Halil Tekiner
- Erciyes University School of Pharmacy, Department of the History of Pharmacy and Ethics. Talas, Kayseri, Turkey
| | - Fan Ye
- University of Central Florida College of Medicine, Graduate Medical Education, 6850 Lake Nona Blvd, Orlando, Florida
| | - Joseph J Mazza
- Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, Wisconsin
| | - Steven H Yale
- University of Central Florida College of Medicine, Department of Internal Medicine, 6850 Lake Nona Blvd, Orlando, Florida
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2
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Corcillo A, Aellen S, Zingg T, Bize P, Demartines N, Denys A. Endovascular treatment of active splenic bleeding after colonoscopy: a systematic review of the literature. Cardiovasc Intervent Radiol 2012; 36:1270-9. [PMID: 23262476 DOI: 10.1007/s00270-012-0539-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 11/22/2012] [Indexed: 12/27/2022]
Abstract
PURPOSE Colonoscopy is reported to be a safe procedure that is routinely performed for the diagnosis and treatment of colorectal diseases. Splenic rupture is considered to be a rare complication with high mortality and morbidity that requires immediate diagnosis and management. Nonoperative management (NOM), surgical treatment (ST), and, more recently, proximal splenic artery embolization (PSAE) have been proposed as treatment options. The goal of this study was to assess whether PSAE is safe even in high-grade ruptures. METHODS We report two rare cases of post colonoscopy splenic rupture. A systematic review of the literature from 2002 to 2010 (first reported case of PSAE) was performed and the three types of treatment compared. RESULTS All patients reviewed (77 of 77) presented with intraperitoneal hemorrhage due to isolated splenic trauma. Splenic rupture was high-grade in most patients when grading was possible. Six of 77 patients (7.8 %) were treated with PSAE, including the 2 cases reported herein. Fifty-seven patients (74 %) underwent ST. NOM was attempted first in 25 patients with a high failure rate (11 of 25 [44 %]) and requiring a salvage procedure, such as PSAE or ST. Previous surgery (31 of 59 patients), adhesions (10 of 13), diagnostic colonoscopies (49 of 71), previous biopsies or polypectomies (31 of 57) and female sex (56 of 77) were identified as risk factors. In contrast, splenomegaly (0 of 77 patients), medications that increase the risk of bleeding (13 of 30) and difficult colonoscopies (16 of 51) were not identified as risk factors. PSAE was safe and effective even in elderly patients with comorbidities and those taking medications that increase the risk of bleeding, and the length of the hospital stay was similar to that after ST. CONCLUSION We propose a treatment algorithm based on clinical and radiological criteria. Because of the high failure rate after NOM, PSAE should be the treatment of choice to manage grade I through IV splenic ruptures after colonoscopy in hemodynamically stabilized patients.
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Affiliation(s)
- Antonella Corcillo
- Département de Médecine Interne, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland,
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3
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Singla S, Keller D, Thirunavukarasu P, Tamandl D, Gupta S, Gaughan J, Dempsey D. Splenic injury during colonoscopy--a complication that warrants urgent attention. J Gastrointest Surg 2012; 16:1225-34. [PMID: 22450952 DOI: 10.1007/s11605-012-1871-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 03/07/2012] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Colonoscopy is a safe procedure that is performed routinely worldwide. There is, however, a small but significant risk of splenic injury that is often under-recognized. Due to a lack of awareness about this injury, the diagnosis may be delayed, which can lead to an increased risk of morbidity as well as mortality. This paper presents a comprehensive review of the medical literature on colonoscopy-associated splenic injury and describes the clinical presentation and management of this rare but potentially life-threatening complication. MATERIALS AND METHODS A comprehensive literature search identified 102 patients worldwide, including patients from our experience, with splenic injury during colonoscopy. A meta-regression analysis was completed using a mixed generalized linear model for repeated measures to identify risk factors for this rare complication. RESULTS A total of 75 articles were identified and 102 patients were studied. The majority of the papers were in English (92 %). Only 23.4 % of patients (26/102) were reported prior to the year 2000. Among the patients reported after the year 2000, the majority (84.2 %, 64/76) were reported after 2005. There were more females (76.5 %), median age was 65 years (range, 29-90 years), and most of the colonoscopies were performed without difficulty (66.6 %). Nearly 67 % of patients presented within 24 h of colonoscopy with complaints ranging from abdominal pain to dizziness. The most common symptom was left upper quadrant pain (58 %), and CT scan was found to be the most sensitive tool for diagnosis. Seventy-three patients underwent operative intervention; 96 % of these were treated with splenectomy. Hemoglobin drop of more than 3 gm/dL was identified as the only significant predictor of operative intervention. The overall mortality rate was 5 %. CONCLUSION Splenic injury during colonoscopy is rare; however, it is associated with significant morbidity and mortality. Splenic injury warrants a high degree of clinical suspicion critical to prompt diagnosis, and early surgical consultation is warranted.
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Affiliation(s)
- S Singla
- Department of Surgery, Temple University Hospital, Philadelphia, PA, USA.
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Zandonà C, Turrina S, Pasin N, De Leo D. Medico-legal considerations in a case of splenic injury that occurred during colonoscopy. J Forensic Leg Med 2012; 19:229-33. [PMID: 22520377 DOI: 10.1016/j.jflm.2011.12.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 11/08/2011] [Accepted: 12/27/2011] [Indexed: 02/07/2023]
Abstract
Colonoscopy has became the gold standard diagnostic and therapeutic treatment for rectum and colon diseases. The splenic injury is a rare complication of colonoscopy and relatively few cases (less than 70) have been reported in the literature so far. Here we present a case of splenic rupture identified in an 80 year-old man few hours after an apparently uneventful colonoscopy. Acknowledging a causal relationship between the lesion and the diagnostic procedures, we discuss the possible medico-legal implications with regard to professional liability considering the exceptional nature of such an event and the stance recently taken by the Italian law.
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Affiliation(s)
- Chiara Zandonà
- Department of Public Health and Community Medicine, Institute of Legal Medicine, University of Verona, Policlinico G.B. Rossi, P.le L.A. Scuro 10, 37134 Verona, Italy
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5
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Splenic rupture after screening colonoscopy: case report and literature review. Surg Laparosc Endosc Percutan Tech 2011; 20:e31-3. [PMID: 20173607 DOI: 10.1097/sle.0b013e3181cc4f62] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Splenic rupture is a rare complication after colonoscopy, and to date there are only 46 reported cases in the English-language literature. Presented is a case report of splenic rupture after screening colonoscopy that resulted in laparotomy and splenectomy within 24 hours of the original procedure. The article covers the hypothesized mechanisms of injury, various precautions to take during colonoscopy, suggested diagnostic algorithm, determining factors in treatment, and vaccine regimen. The article concludes by stating that as the number of colonoscopies increase, so will the prevalence of associated complications, and that physicians are encouraged to understand this paradigm shift.
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6
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Michetti CP, Smeltzer E, Fakhry SM. Splenic injury due to colonoscopy: analysis of the world literature, a new case report, and recommendations for management. Am Surg 2011; 76:1198-204. [PMID: 21140684 DOI: 10.1177/000313481007601117] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Splenic injury is a rare complication of colonoscopy. Most literature on the topic is case-report based. Our objective was to perform a comprehensive analysis of characteristics of splenic injury due to colonoscopy from available published reports in the world literature, to compare and contrast this entity with that of traumatic splenic injury, and provide recommendations for management based on the analysis. We reviewed the PubMed database without restrictions using the terms splenic trauma after colonoscopy, splenic rupture from colonoscopy, splenic injury following colonoscopy, and splenic complications of colonoscopy, and also reviewed the references from the resulting publications. Retrieved manuscripts (case reports, reviews, and abstracts) were reviewed by two authors, and data extracted for 15 specific characteristics of each patient reported using a standardized data collection tool. Data were analyzed using descriptive statistics. Splenic injury due to colonoscopy is extremely rare as reported in published literature. The majority of patients that seek medical attention have delayed symptoms, and most require splenectomy. Subcapsular hematoma is the most common injury pattern seen. Selection criteria for operative management may be extrapolated from management guidelines for traumatic splenic injury, although nonoperative failure rates are higher for splenic injury due to colonoscopy than for trauma.
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Affiliation(s)
- Christopher P Michetti
- Inova Regional Trauma Center, Inova Fairfax Hospital, Falls Church, Virginia 22042, USA.
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7
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Shah PR. Splenic injury following colonoscopy. Ann R Coll Surg Engl 2010; 92:268; author reply 269. [PMID: 20412679 DOI: 10.1308/003588410x12664192075413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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8
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Wasson J, Karim H, Yeo J, Panesar J. Authors' Response. Ann R Coll Surg Engl 2010. [DOI: 10.1308/003588410x12664192075332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- J Wasson
- Luton and Dunstable Hospital NHS Foundation Trust Luton, UK
| | - H Karim
- Luton and Dunstable Hospital NHS Foundation Trust Luton, UK
| | - J Yeo
- Luton and Dunstable Hospital NHS Foundation Trust Luton, UK
| | - J Panesar
- Luton and Dunstable Hospital NHS Foundation Trust Luton, UK
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9
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Splenic rupture as a complication of colonoscopy: report of a case. Surg Today 2009; 40:68-71. [PMID: 20037844 DOI: 10.1007/s00595-008-3977-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Accepted: 12/19/2008] [Indexed: 10/20/2022]
Abstract
Colonoscopy is a common procedure with the rare complication of a splenic injury. The proposed mechanism of injury is excessive splenocolic ligament traction. The diagnosis is made by computed tomography and the treatment is determined by the patient's stability. Here we report a case of splenic injury during colonoscopy with failure to manage conservatively. A review of the literature and suggested guidelines are also provided.
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10
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Skipworth JRA, Raptis DA, Rawal JS, Olde Damink S, Shankar A, Malago M, Imber C. Splenic injury following colonoscopy--an underdiagnosed, but soon to increase, phenomenon? Ann R Coll Surg Engl 2009; 91:W6-11. [PMID: 19416579 DOI: 10.1308/147870809x400994] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION We present a case of splenic rupture in a 71-year-old woman admitted 6 days following a diagnostic colonoscopy. She underwent an open splenectomy and made a delayed, but complete, recovery. We proceeded to perform a retrospective review of all relevant literature to assess the frequency of similar post-colonoscopy complications. MATERIALS AND METHODS Using relevant keywords, we identified 63 further PubMed reports of splenic injury associated with colonoscopy that were reported in English. FINDINGS We have described only the fourth report of splenic injury secondary to colonoscopy from a UK centre. Literature review reveals a mean age of 63 years and a female preponderance for this complication. Most patients present on the day of their colonoscopy with abdominal pain, anaemia, elevated white cell count and Kehr's sign. CT is the investigation of choice and splenectomy the definitive management of choice. Most patients make a routine recovery, with mortality rates of approximately 8%. There is likely to be an under-reporting of this complication from UK-based centres, with the majority of reports originating from Europe and US. This points to a possible under-diagnosis or under-recognition of this potentially fatal complication. The incidence of such post-colonoscopic complications may increase with the forthcoming introduction of the National Bowel Cancer Screening Programme.
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Affiliation(s)
- J R A Skipworth
- Department of Hepatopancreaticobiliary Surgery, University College Hospital, London, UK.
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11
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Ha JF, Minchin D. Splenic injury in colonoscopy: a review. Int J Surg 2009; 7:424-7. [PMID: 19638324 DOI: 10.1016/j.ijsu.2009.07.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Accepted: 07/22/2009] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Splenic rupture secondary to colonoscopy was first reported in 1974 by Wherry and Zehner. It has an incidence of around 0.00005-0.017%, and a mortality rate of 5%. METHOD We performed a literature search to identify the demographic profile, risk factors, clinical presentations, diagnosis and management of this rare complication. RESULTS There were 66 patients (51 females and 14 males), with a median age of 65. The mortality rate was 4.5%. Majority (n=41, 62.1%) occurred in uneventful colonoscopies. Symptoms usually (74%) occurred within 24h, and 55.8% presented within 24h. Majority (93.9%) had some form of work-up done, with blood tests (78.8%) and CT (68.2%) being the most frequent. Laparotomy and splenectomy were done in over half (56.1%) of the patients. Splenic hematoma (47%), laceration (47%) and rupture (33.3%) were the most common findings. CONCLUSION Splenic injury is an important complication to be aware of as its number will continue to rise with the increasing numbers of colonoscopies being performed for colorectal diseases, and delayed diagnosis may result in adverse outcome for the patient.
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Affiliation(s)
- Jennifer Fong Ha
- Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands 6009, Western Australia, Australia.
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12
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Saad A, Rex DK. Colonoscopy-induced splenic injury: report of 3 cases and literature review. Dig Dis Sci 2008; 53:892-8. [PMID: 17934832 DOI: 10.1007/s10620-007-9963-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Accepted: 08/01/2007] [Indexed: 12/12/2022]
Abstract
BACKGROUND Since its first report in 1974, 66 cases of splenic injury after colonoscopy have been reported in the world literature. Splenic injury is among the rarest complications of colonoscopy. However, it can be associated with severe morbidity and has rarely been fatal. OBJECTIVES Three cases of splenic injury following colonoscopy are described, and the world literature is reviewed. METHODS Case reports and literature review. RESULTS Seventy-six percent of the patients were females. When reported, colonoscope insertion was technically difficult in 36% of cases. The onset of symptoms is usually within 48 h of colonoscopy. Abdominal pain was the most common presenting symptom (93% of cases). CT scan and ultrasound each had 100% diagnostic sensitivity when performed. Twenty of 65 cases (31%) with available data were successfully managed supportively with bed rest, transfusion and pain control. Hemodynamic instability was associated with surgical treatment, but no clinical features were perfect predictors of successful conservative therapy or the need for surgery. CONCLUSIONS Splenic injury during and after colonoscopy is more common in women. Technically difficult colonoscopy is a possible risk factor. Onset of symptoms is often delayed by hours. CT scan is probably the best diagnostic test for splenic injury after colonoscopy, though the literature indicated ultrasound is also sensitive. Patients with hemodynamic instability are most often operated. Patients with confined intrasplenic hematoma and hemodynamic stability can be given a trial of conservative management.
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Affiliation(s)
- Abdo Saad
- Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, 550 N. University Boulevard UH 4100, Indianapolis, IN 46202, USA
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Cappellani A, Di Vita M, Zanghì A, Cavallaro A, Alfano G, Piccolo G, Lo Menzo E. Splenic rupture after colonoscopy: Report of a case and review of literature. World J Emerg Surg 2008; 3:8. [PMID: 18261241 PMCID: PMC2279110 DOI: 10.1186/1749-7922-3-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 02/09/2008] [Indexed: 11/25/2022] Open
Abstract
Splenic rupture is a rare complication of colonoscopy. For this reason the diagnosis could be delayed and the outcome dismal. Fifty-four cases of splenic rupture after colonoscopy have been described in the literature. The majority of the cases required emergent or delayed splenectomy, 13 of these cases were treated conservatively. The main feature that stands out from the review of the literature is the "surprise" of this unexpected complication. This factor explains the elevated mortality (2 out of 54 cases), likely due to the delay in diagnosis. The case here described is probably among the most complex published in the literature; in fact the presence of dense intra-abdominal adhesions not only contributed to the complication itself, but also explain the confinement of the hemoperitoneum to the left supra-mesocolic space and the delayed presentation (13 days from the time of the trauma).
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Affiliation(s)
- Alessandro Cappellani
- University of Catania Medical School, Policlinico, Department of Surgery, Catania, Italy
| | - Maria Di Vita
- University of Catania Medical School, Policlinico, Department of Surgery, Catania, Italy
| | - Antonio Zanghì
- University of Catania Medical School, Policlinico, Department of Surgery, Catania, Italy
| | - Andrea Cavallaro
- University of Catania Medical School, Policlinico, Fellowship in Surgical Physio-Pathology, Catania, Italy
| | - Giovanni Alfano
- University of Catania Medical School, Policlinico, Department of Surgery, Catania, Italy
| | - Gaetano Piccolo
- University of Catania Medical School, Policlinico, Department of Surgery, Catania, Italy
| | - Emanuele Lo Menzo
- University of Miami, Miller School of Medicine, Department of Surgery, Miami, Florida, USA
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Burnot A, Gauchet G, Baccot S, Lévy M, Cathébras P. Une complication rare de la coloscopie: la rupture de rate. Rev Med Interne 2006. [DOI: 10.1016/j.revmed.2006.10.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lee YT, Wu HS, Hung MC, Lin ST, Hwang YS, Huang MH. Ruptured appendiceal cystadenoma presenting as right inguinal hernia in a patient with left colon cancer: a case report and review of literature. BMC Gastroenterol 2006; 6:32. [PMID: 17074081 PMCID: PMC1634861 DOI: 10.1186/1471-230x-6-32] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2006] [Accepted: 10/30/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mucoceles resulting from cystadenomas of the appendix are uncommon. Although rare, rupture of the mucoceles can occur with or without causing any abdominal complaint. There are several reports associating colonic malignancy with cystadenomas of the appendix. Herein, we report an unusual and interesting case of right inguinal hernia associated with left colon cancer. CASE PRESENTATION A case of ruptured mucocele resulting from cystadenoma of the appendix was presented as right inguinal hernia in a 70-year-old male. The patient underwent colonoscopy, x-ray, ultrasound and computed tomography. Localized pseudomyxoma peritonei associated with adenocarcinoma of the descending colon was diagnosed. The patient underwent segmental resection of the colon, appendectomy, debridement of pseudomyxoma and closure of the internal ring of right inguinal canal. He is free of symptoms in one year follow-up. CONCLUSION Synchronous colon cancer may occur in patients with appendiceal mucoceles. In such patients, the colon should be investigated and colonoscopy can be performed meticulously in cases of ruptured mucoceles and localized pseudomyxoma peritonei. Surgical intervention is the current choice of management.
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Affiliation(s)
- Yueh-Tsung Lee
- Department of Surgery, Division of general surgery, Chang-Bing Show Chwan Memorial Hospital, Lu-Gang, Taiwan
| | - Hurng-Sheng Wu
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Min-Chang Hung
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Shang-Tao Lin
- Department of Pathology, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Yome-Shine Hwang
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Min-Ho Huang
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
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Luebke T, Baldus SE, Holscher AH, Monig SP. Splenic Rupture: An Unusual Complication of Colonoscopy. Surg Laparosc Endosc Percutan Tech 2006; 16:351-4. [PMID: 17057581 DOI: 10.1097/01.sle.0000213703.94687.50] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Splenic rupture after colonoscopy is rare. Only 44 cases previously have been reported in the English literature. Partial capsular avulsion is the proposed mechanism of injury. Any condition causing increased splenocolic adhesions may be a predisposing factor to splenic injury. One case of splenic injury after colonoscopy is reported in addition to a complete review of the literature.
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Affiliation(s)
- Thomas Luebke
- Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany.
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