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Splenic Injury

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121. The spleen contributes importantly to myocardial infarct exacerbation during post-ischemic reperfusion in mice via signaling between cardiac HMGB1 and splenic RAGE (PubMed)

The spleen contributes importantly to myocardial infarct exacerbation during post-ischemic reperfusion in mice via signaling between cardiac HMGB1 and splenic RAGE The spleen plays a critical role in post-infarct myocardial remodeling. However, the role of the spleen in exacerbating myocardial infarction (MI) during acute ischemia/reperfusion (I/R) injury is unknown. The present study tests the hypothesis that splenic leukocytes are activated by substances released from ischemic myocardium (...) to subsequently exacerbate myocardial injury during reperfusion. The left coronary artery in C57BL/6 mice underwent various durations of occlusion followed by 60 min of reperfusion (denoted as min/min of I/R) with or without splenectomy prior to I/R injury. Splenectomy significantly decreased myocardial infarct size (IS) in 40'/60' and 50'/60' groups (p < 0.05); however, it had no effect on IS in 10'/60', 20'/60' and 30'/60' groups (p = NS). In the 20'/60' group, infusion of 40-min ischemic heart homogenate

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2016 Basic research in cardiology

122. Necrosis of the tail of pancreas following proximal splenic artery embolization (PubMed)

Necrosis of the tail of pancreas following proximal splenic artery embolization The current case report presents a rare complication of a significant pancreatic tail necrosis following proximal splenic artery embolization in a 32-year-old male patient involved in a motorcycle accident. Proximal angiographic embolization of the splenic injury after trauma is a widely accepted method with excellent success rate; however, possible complications may occur and has been described in the literature

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2016 Journal of surgical case reports

123. A rare case of occult splenic rupture after left pneumonectomy (PubMed)

A rare case of occult splenic rupture after left pneumonectomy Cardiopulmonary resuscitation (CPR) techniques are now well-established and play a crucial role in improving survival in cardiac arrest. Recognized complications associated with CPR include injury to the upper abdominal viscera, including the liver, stomach and spleen. We present a rare case of occult splenic rupture following cardiac arrest in a 63-year-old male immediately after left pneumonectomy. We discuss potential mechanisms (...) predisposing the spleen to injury in this case, and highlight the difficulty of promptly identifying such a traumatic injury within the confines of a cardiac arrest scenario. Clinicians should be aware that anatomical changes following thoracic surgery may render the intra-abdominal viscera at increased risk of injury following CPR. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

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2016 Journal of surgical case reports

124. Accessory Spleen in the Splenic Hilum: a Cadaveric Study with Clinical Significance (PubMed)

Accessory Spleen in the Splenic Hilum: a Cadaveric Study with Clinical Significance An accessory spleen is an additional tissue of the spleen that may be found near the spleen. It is a congenital anomaly of the spleen that its incidence has been reported 10-30% of the population. Hence, the objective of this study was evaluation the incidence of accessory spleen in Iranian cadavers.Sixty hundred and ninety three spleens (541 males, 152 females) were excised from cadavers in the dissection hall (...) of Mashhad Forensic Medicine Organization cadavers. Inclusion criteria were as follows: Fresh Iranian cadavers with no history of alcohol, poisoning or drug abuse, and no evidence of pathologic abnormality or injury to the spleen. The presence of accessory spleens, its dimension and weight investigated in cadavers.During routine postmortem examination, five cases with an accessory spleen were found in the autopsy laboratory of Mashhad legal Medicine Organization between June 2014 and July 2015

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2016 Medical Archives

125. Combined Resection vs. Separated Resection After Mobilization of Splenic Vein During Distal Pancreatectomy

Combined Resection vs. Separated Resection After Mobilization of Splenic Vein During Distal Pancreatectomy Combined Resection vs. Separated Resection After Mobilization of Splenic Vein During Distal Pancreatectomy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100 (...) ). Please remove one or more studies before adding more. Combined Resection vs. Separated Resection After Mobilization of Splenic Vein During Distal Pancreatectomy (COSMOS-DP) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier

2016 Clinical Trials

126. Laparoscopic Versus Open Gastrectomy With Splenic Hilum Lymph Nodes Dissection

to the tortuous splenic vessels and the high possibility of injury to the parenchyma of the spleen and pancreas. Recently, the application of minimally invasive surgery for advanced gastric cancer is gaining popularity. However, laparoscopic total gastrectomy (LTG) with standard D2 lymphadenectomy was still not widely performed, because pancreas- and spleen-preserving splenic hilum lymph node dissection were mainly challenging manipulations for laparoscopic surgeons. Therefore,the investigators aim (...) Laparoscopic Versus Open Gastrectomy With Splenic Hilum Lymph Nodes Dissection Laparoscopic Versus Open Gastrectomy With Splenic Hilum Lymph Nodes Dissection - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more

2016 Clinical Trials

127. Laparoscopic-assisted Total Gastrectomy Versus Open Total Gastrectomy With Splenic Hilum Lymph Nodes Dissection

) dissection along the splenic artery (No.11) and the splenic hilum (No.10) is recommended by the Japanese Gastric Cancer Treatment Guidelines. Nevertheless, complete removal of the No. 10 and No. 11d LNs is technically challenging due to the tortuous splenic vessels and the high possibility of injury to the parenchyma of the spleen and pancreas. Recently, the application of minimally invasive surgery for advanced gastric cancer is gaining popularity. However, laparoscopic-assisted total gastrectomy (LATG (...) Laparoscopic-assisted Total Gastrectomy Versus Open Total Gastrectomy With Splenic Hilum Lymph Nodes Dissection Laparoscopic-assisted Total Gastrectomy Versus Open Total Gastrectomy With Splenic Hilum Lymph Nodes Dissection - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved

2016 Clinical Trials

128. Effect of Tapentadol on Splenic Cytokine Production in Mice. (PubMed)

cytokine in normal and in hyperalgesia/allodynia mice, comparing it with morphine and reboxetine, a noradrenaline reuptake inhibitor.Tapentadol, reboxetine, and morphine were injected subcutaneously into naïve and mice that underwent sciatic nerve chronic constriction injury, and their effect on splenic cytokines (interferon-γ [IFN-γ], interleukin [IL]-2, IL-10, and IL-4) was measured by enzyme-linked immunosorbent assay after acute or chronic treatment. Nociceptive thresholds, thermal hyperalgesia (...) Effect of Tapentadol on Splenic Cytokine Production in Mice. Opioid drugs affect immunity, but not all opioid drugs share the same immunomodulatory properties. Tapentadol is an analgesic drug with a dual synergistic mechanism of action: µ-opioid receptor agonism and noradrenaline reuptake inhibition. Weaker µ-opioid receptor agonism combined with noradrenaline reuptake inhibition results in potent analgesia with reduced opioid side effects. We evaluated the impact of tapentadol on splenic

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2016 Anesthesia and Analgesia

129. "Primary Care of the Blunt Splenic Injured Adult". (PubMed)

"Primary Care of the Blunt Splenic Injured Adult". The spleen is the most commonly injured abdominal organ in blunt trauma. Immediate treatment is aimed at assessing for bleeding and abating it when it is severe. Methods for the management of blunt splenic injury-associated bleeding include observation, splenectomy, and splenic salvage procedures through splenorrhaphy or embolization. After blunt splenic injury, complications commonly occur, including bleeding, infection, thrombosis (...) , and pneumonia. If a patient undergoes splenectomy, infections can be severe. To mitigate infectious complications after splenectomy, vaccination against common pathogens remains paramount. Patients may often present to their primary care provider with complaints related to splenic injury or long-term care of their immunocompromised state. Knowledge of the spleen's function, as well as common complications and risks, is important to physicians caring for splenic injury patients. This narrative review

2016 American Journal of Medicine

130. Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading (PubMed)

we describe an extremely rare condition in a case that presented with a DSR following blunt trauma and had a normal appearing spleen in the initial post trauma MDCT scan.DSR is a serious consequence of trauma and is associated with a significantly higher mortality rate compared with the overall mortality for acute splenic injuries. A High index of suspicion along with the liberal serial utilization of the imaging studies are the essential elements for early detection of DSR. We propose that DSR (...) be considered as a differential diagnosis in patients presenting with hemodynamic instability late post trauma, even when the immediate post trauma MDCT scan has shown a normal appearing spleen. We suggest that every patient with a high impact injury or injuries to peri-splenic organs should have a repeat MDCT scan 2 - 3 days post trauma or before the patients is discharged from hospital.

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2016 Trauma monthly

131. Splenic rupture following colonoscopy: Case report and literature review (PubMed)

Splenic rupture following colonoscopy: Case report and literature review Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for colorectal diseases. Although bleeding and perforation are most common complications, extra colonic or visceral injuries have been described. Splenic rupture is rare with few cases reported in current literature.We report the case of a 73-year old man who presented to surgical consultation 50h after colonoscopy. Clinical, laboratory (...) and imaging findings were suggestive for haemoperitoneum. At surgery an almost complete splenic disruption was evident and urgent splenectomy was performed.Splenic injury following colonoscopy is exceptional, probably related to instrumental looping with excessive traction on the splenocolic ligament. In patients with an early presentation a sudden onset of symptoms is the rule. By contrast a delayed presentation (>48h) is nonspecific and subtle with arduous diagnosis.Awareness of this potential

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2016 International journal of surgery case reports

132. Acute tumor lysis syndrome after proximal splenic artery embolization (PubMed)

Acute tumor lysis syndrome after proximal splenic artery embolization Preoperative splenic artery embolization for massive splenomegaly has been shown to reduce intraoperative hemorrhage during splenectomy. We describe a case of tumor lysis syndrome after proximal splenic artery embolization in a patient with advanced mantle cell lymphoma and splenic involvement. The patient presented initially with hyperkalemia two days after embolization that worsened during splenectomy. He was stabilized (...) , but developed laboratory tumor lysis syndrome with renal failure and expired. High clinical suspicion of tumor lysis syndrome in this setting is advised. Treatment must be started early to avoid serious renal injury and death. Lastly, same day splenectomy and embolization should be considered to decrease the likelihood of developing tumor lysis syndrome.

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2016 Radiology Case Reports

133. Imaging findings of splenic emergencies: a pictorial review (PubMed)

Imaging findings of splenic emergencies: a pictorial review Although traumatic injuries are the cause of common splenic emergencies in the emergency room, various nontraumatic conditions may also affect the spleen with possible life-threatening results. In this pictorial review, we present imaging findings of usual and unusual splenic emergencies. It is essential to be familiar with key imaging findings and advantages of different modalities to reach a definitive diagnosis.• Delayed splenic (...) rupture is commonly related to subcapsular hematoma. • Subtle haemorrhage is commonly restricted to the site of injury "sentinel clot sign". • The whorled appearance is the key imaging feature of splenic torsion.

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2016 Insights into imaging

134. Spleen hypoplasia leads to abnormal stress hematopoiesis in mice with loss of Pbx homeoproteins in splenic mesenchyme (PubMed)

stresses such as myeloablation, blood loss, or pregnancy. Our results demonstrate that, in addition to their intrinsic roles in HSPCs, non-cell autonomous functions of Pbx factors within the splenic niche contribute to the regulation of hematopoiesis, at least in part via the control of KitL/SCF and Cxcl12/SDF-1. Furthermore, our study establishes that abnormal spleen development and hypoplasia have deleterious effects on the efficiency of hematopoietic recovery after bone marrow injury.© 2016 (...) Spleen hypoplasia leads to abnormal stress hematopoiesis in mice with loss of Pbx homeoproteins in splenic mesenchyme The spleen plays critical roles in immunity and also provides a permissive microenvironment for hematopoiesis. Previous studies have reported that the TALE-class homeodomain transcription factor Pbx1 is essential in hematopoietic stem and progenitor cells (HSPCs) for stem cell maintenance and progenitor expansion. However, the role of Pbx1 in the hematopoietic niche has not been

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2016 Journal of anatomy

135. Thrombocytosis in splenic trauma: In-hospital course and association with venous thromboembolism. (PubMed)

, but the need for this agent in splenic trauma is undefined.Retrospective cohort study of all patients with splenic trauma between April 1, 2010 and March 31, 2014. The in-hospital course of PC was assessed based on splenic injury management type. The association of management type with thrombocytosis was evaluated using a multivariable logistic regression model adjusting for potential confounders. The association of thrombocytosis, extreme thrombocytosis, and ASA use for the outcome of VTE was explored.156 (...) patients were eligible, PC initially increased in all patients with the highest peak after total splenectomy. The incidence of thrombocytosis was 41.0% (64/156). Thrombocytosis was more likely following splenectomy compared with spleen preserving strategies independent of length of stay, injury grade, ISS, age and transfusion (OR 7.58, 95% CI: 2.26-25.45). Splenectomy was associated with extreme thrombocytosis (OR 10.39, 95% CI: 3.59-30.07).Thrombocytosis in splenic trauma is more likely after

2016 Injury

136. Case report-delayed splenic rupture in combination with medial femoral neck fracture after low energy trauma. Development of hemorrhagic shock 5 days after hip prosthesis due to a rare cause (PubMed)

and the spleen was resected. Histopathological examination showed a delayed rupture of an otherwise normal spleen without signs of an underlying pathology. The outcome was fatal: In the postoperative course she developed pneumonia, three weeks later she succumbed due to multiple organ failure. Even careful reevaluation of the case did not provide any clues to expect an injury of the spleen according to trauma mechanism. This case shows that delayed splenic rupture of a normal spleen may occur even after (...) a low energy trauma. Injury of the spleen should therefore always be considered, even with an uncharacteristic anamnesis. Physical examination after trauma should therefore always include a careful clinical evaluation. The clinical threshold for a FAST examination should be low. The coincidence of a femoral neck fracture and a splenic rupture after a low energy trauma has not been reported before.

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2016 Trauma Case Reports

137. Splenic artery embolization: technically feasible but not necessarily advantageous (PubMed)

Splenic artery embolization: technically feasible but not necessarily advantageous The spleen is the second most commonly injured organ in cases of abdominal trauma. Management of splenic injury depends on the clinical status of the patient and can include nonoperative management (NOM), splenic artery embolization (SAE), surgery (operative splenic salvage or splenectomy), or a combination of these treatments. In nonoperatively managed cases, SAE is sometimes used to control haemorrhage. However (...) , the indications for SAE have not been clearly defined and, in some cases, the potential complications of the procedure may outweigh its benefits.Through review of the literature we address the question of when SAE is indicated in combination with NOM of splenic injury, and whether SAE may delay needed surgical treatment in some cases. This systematic review highlighted the use of imperfect and inconsistent scoring systems in the diagnosis of splenic injury, the lack of consensus regarding indications for SAE

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2016 World journal of emergency surgery : WJES

138. Pancreatic Injuries

treated at a level 1 trauma centre. S Afr J Surg . 2011;49(2: 58, 60, 2–4 passim). Robey E, Mullen JT, Schwab CW. Blunt transection of the pancrease treated by distal pancreatectomy, splenic salvage and hyperalimentation. Four cases and review of the literature. Ann Surg . 1982;196(6):695–699. Ivatury RR, Nallathambi M, Rao P, Stahl WM. Penetrating pancreatic injuries. Analysis of 103 consecutive cases. Am Surg . 1990;56(2):90–95. Nance FC, DeLoach DH. Pancreaticoduodenectomy following abdominal (...) , Kazigo J, Gunduz Y, Stahl WM. The spleen at risk after penetrating trauma. J Trauma . 1993;35(3):409–414. Pachter HL, Hofstetter SR, Liang HG, Hoballah J. Traumatic injuries to the pancreas: the role of distal pancreatectomy with splenic preservation. J Trauma . 1989;29(10):1352–1355. Sriussadaporn S. Management of pancreatic injuries. J Med Assoc Thai . 1994;77(11):580–587. Yadav TD, Natarajan SK, Kishore VM, Lyngdoh S, Wig JD. Spleen-preserving distal pancreatectomy for pancreatic trauma: a series

2017 Eastern Association for the Surgery of Trauma

139. Superselective splenic artery embolization for the management of splenic laceration following colonoscopy (PubMed)

Superselective splenic artery embolization for the management of splenic laceration following colonoscopy Splenic injury is a rare complication following colonoscopy with fewer than 100 reported cases worldwide to date. We describe a case of splenic laceration presenting 5 days following diagnostic colonoscopy. Although hemodynamically stable, active contrast extravasation on contrast-enhanced multidetector computed tomography predicted likely failure of conservative management. Splenic artery (...) angiography confirmed active extravasation from the lower splenic pole and the patient was successfully treated with super selective coil embolization of a lower pole splenic artery branch. This is the eighth reported case of endovascular treatment of splenic injury following colonoscopy. To our knowledge, however, superselective splenic artery embolization has not been previously reported to treat this rare endoscopic complication.

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2014 Acta Radiologica Short Reports

140. Nonoperative management of adult blunt splenic injury with and without splenic artery embolotherapy: a meta-analysis. (PubMed)

Nonoperative management of adult blunt splenic injury with and without splenic artery embolotherapy: a meta-analysis. Observation and splenic artery embolotherapy (SAE) are nonoperative management (NOM) modalities for adult blunt splenic injury; however, they are quite different, inconsistently applied, and controversial. This meta-analysis compares the known outcomes data for observational management versus SAE by splenic injury grade cohort.Thirty-three blunt splenic injury outcomes articles (...) , published between 1994 and 2009, comprising 24 unique data sets are identified. Of these, nine gave outcomes data by splenic injury grade for observational management and SAE separately. Failure rates were collected and analyzed using random effects estimates.Overall, 68.4% of the 10,157 patients were managed nonoperatively. The overall failure rate estimate of NOM is 8.3% with a 95% confidence interval (CI) of 6.7% to 10.2%. The observational management failure rate estimate without SAE increases from

2011 Journal of Trauma

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