Limits...
Hypoplasia of the Spleen: Review of Pathogenesis, Diagnosis, and Potential Clinical Implications.

Sucandy I, Polavarapu HV, Pezzi CM - N Am J Med Sci (2015)

Bottom Line: We present an unusual case of hypoplastic spleen with calcifications, which was preoperatively found during radiologic workup for gastric carcinoma.During laparotomy, an atrophied and calcified spleen was identified and left in situ.The patient made an uneventful postoperative recovery.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania 19001, USA.

ABSTRACT

Context: Splenic aplasia is seen when the spleen is congenitally absent, has been surgically removed, or becomes atrophic secondary to episodes of arterial/venous occlusion, which result in splenic infarction. This rare condition is caused by a heterogenous group of diseases, which may present a wide spectrum of clinical manifestations. Splenic hypoplasia is defined as reduction in splenic mass and or functions caused by incomplete splenic development or secondary parenchymal involution. Splenic infarction may be clinically silent and only discovered incidentally during abdominal exploration for other conditions.

Case report: We present an unusual case of hypoplastic spleen with calcifications, which was preoperatively found during radiologic workup for gastric carcinoma. An 88-year-old woman presented with coffee-ground emesis. Her past medical history was only significant for atrial fibrillation. Esophagogastroduodenoscopy demonstrated gastric carcinoma, for which a subtotal gastrectomy was planned. Preoperative computed tomography scan showed a hypoplastic spleen with calcifications in the left upper quadrant. Symptoms of immunologic deficiency were not present. During laparotomy, an atrophied and calcified spleen was identified and left in situ. The patient made an uneventful postoperative recovery. Splenic hypoplasia is an unique entity, which may be seen in the setting of atrial fibrillation and abdominal malignancy.

Conclusion: Splenic hypoplasia may be detected incidentally during radiologic workup or abdominal exploration. Abdominal symptoms or immunologic deficiency are not always present.

No MeSH data available.


Related in: MedlinePlus

Coronal section of the abdominal computed tomography scan showing the hypoplastic and calcified spleen
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4561443&req=5

Figure 1: Coronal section of the abdominal computed tomography scan showing the hypoplastic and calcified spleen

Mentions: An 88-year-old Caucasian woman presented with coffee-ground emesis. Her past medical history was significant for atrial fibrillation. Esophagogastroduodenoscopy demonstrated the presence of a gastric adenocarcinoma, for which open subtotal gastrectomy was planned. Preoperative computed tomography (CT) showed an aplastic spleen with calcifications in the left upper quadrant [Figure 1]. Symptoms of immunologic deficiency were not present. During laparotomy, an atrophied and calcified spleen was identified [Figure 2]. The aplastic spleen was left in place. The patient made a full postoperative recovery without any complications.


Hypoplasia of the Spleen: Review of Pathogenesis, Diagnosis, and Potential Clinical Implications.

Sucandy I, Polavarapu HV, Pezzi CM - N Am J Med Sci (2015)

Coronal section of the abdominal computed tomography scan showing the hypoplastic and calcified spleen
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4561443&req=5

Figure 1: Coronal section of the abdominal computed tomography scan showing the hypoplastic and calcified spleen
Mentions: An 88-year-old Caucasian woman presented with coffee-ground emesis. Her past medical history was significant for atrial fibrillation. Esophagogastroduodenoscopy demonstrated the presence of a gastric adenocarcinoma, for which open subtotal gastrectomy was planned. Preoperative computed tomography (CT) showed an aplastic spleen with calcifications in the left upper quadrant [Figure 1]. Symptoms of immunologic deficiency were not present. During laparotomy, an atrophied and calcified spleen was identified [Figure 2]. The aplastic spleen was left in place. The patient made a full postoperative recovery without any complications.

Bottom Line: We present an unusual case of hypoplastic spleen with calcifications, which was preoperatively found during radiologic workup for gastric carcinoma.During laparotomy, an atrophied and calcified spleen was identified and left in situ.The patient made an uneventful postoperative recovery.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania 19001, USA.

ABSTRACT

Context: Splenic aplasia is seen when the spleen is congenitally absent, has been surgically removed, or becomes atrophic secondary to episodes of arterial/venous occlusion, which result in splenic infarction. This rare condition is caused by a heterogenous group of diseases, which may present a wide spectrum of clinical manifestations. Splenic hypoplasia is defined as reduction in splenic mass and or functions caused by incomplete splenic development or secondary parenchymal involution. Splenic infarction may be clinically silent and only discovered incidentally during abdominal exploration for other conditions.

Case report: We present an unusual case of hypoplastic spleen with calcifications, which was preoperatively found during radiologic workup for gastric carcinoma. An 88-year-old woman presented with coffee-ground emesis. Her past medical history was only significant for atrial fibrillation. Esophagogastroduodenoscopy demonstrated gastric carcinoma, for which a subtotal gastrectomy was planned. Preoperative computed tomography scan showed a hypoplastic spleen with calcifications in the left upper quadrant. Symptoms of immunologic deficiency were not present. During laparotomy, an atrophied and calcified spleen was identified and left in situ. The patient made an uneventful postoperative recovery. Splenic hypoplasia is an unique entity, which may be seen in the setting of atrial fibrillation and abdominal malignancy.

Conclusion: Splenic hypoplasia may be detected incidentally during radiologic workup or abdominal exploration. Abdominal symptoms or immunologic deficiency are not always present.

No MeSH data available.


Related in: MedlinePlus