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Carlo Salvarani - One of the best experts on this subject based on the ideXlab platform.
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wegener granulomatosis with Spleen Infarction case report and review of the literature
Seminars in Arthritis and Rheumatism, 2008Co-Authors: A Ghinoi, Nicolo Pipitone, Alberto Cavazza, Luigi Boiardi, Carlo SalvaraniAbstract:Objective To report a case of biopsy-verified Wegener granulomatosis (WG) with positive c-antineutrophil cytoplasmic antibodies who had evidence of Spleen Infarction and to review the relevant literature on Spleen involvement in WG. Methods Descriptive case report of 1 patient with WG complicated by Spleen Infarction and review of the relevant literature (PubMed search 1966 through February 2007). Results In our patient Spleen involvement (Infarction) was clinically silent and was incidentally detected on the caudal slides of a chest computed tomography (CT) performed to investigate pulmonary involvement. Similar cases have been reported: in the published literature reviewed, overall 18 patients have been described and other cases have been described after autopsy. Of these, 8 patients were symptomatic: generally, they complained of diffuse or left upper quadrant abdominal pain. In 15 patients, Spleen involvement was detected by ultrasound, scintigraphy, CT scan, or magnetic resonance imaging. In 1 case only was the diagnosis confirmed by biopsy (after splenectomy). Conclusions The frequency of Spleen Infarction is probably underestimated in WG since it is often clinically silent as in our patient. In addition to Spleen Infarction, WG has also been implicated in inducing Spleen hemorrhage, capsular adhesions, dysfunction, and splenomegaly. Since some of the Spleen lesions may lead to complications, a high index of suspicion should be maintained for Spleen involvement in patients with WG, particularly in the presence of abdominal symptoms.
J L Kemeny - One of the best experts on this subject based on the ideXlab platform.
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Spleen haemorrhagic Infarction and hazards of anticoagulation in wegener s granulomatosis
Annals of the Rheumatic Diseases, 1999Co-Authors: Thomas Papo, Du Le Thi Huong, Jeancharles Piette, Marc Andre, Olivier Aumaitre, Frederic Charlotte, J L KemenyAbstract:In the largest cohort published to date, no splenic involvement is described in Wegener’s granulomatosis (WG).1 We report on two patients who required splenectomy for symptomatic Spleen Infarction in the course of WG. ### CASE 1 A 42 year old man was admitted with an eight month history of arthritis and lower limb dysesthesia. Examination showed an acutely ill patient with a 39°C fever, oral ulcers, haemorrhagic gingival hyperplasia, bilateral haemorrhagic nasal discharge with crusts, diffuse necrotic purpura, neuritis, and black discoloration of some fingers and toes. The Spleen was not palpable. Silent anterior myocardial Infarction was diagnosed because of raised MB-CK levels and ST-segment increase with loss of R waves in leads V1,V2,V3 on electrocardiogram.2Antineutrophil cytoplasmic antibodies (c-ANCA) were disclosed in serum and necrotising vasculitis was shown on skin biopsy specimen.3 No antiphospholipid antibody or coagulation protein abnormality could be disclosed. Treatment consisted of intravenous administration of prednisolone, cyclophosphamide, sodium heparinate, diltiazem, dinitrosorbide and enalapril. His short-term course was uneventful. At day 14, the …
Defei Hong - One of the best experts on this subject based on the ideXlab platform.
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treatment of distal splenic artery aneurysm by laparoscopic aneurysmectomy with end to end anastomosis a case report
Medicine, 2017Co-Authors: Yuhua Zhang, Zhenjie Liu, Guoliang Shen, Jungang Zhang, Carmel Rebecca Assa, Defei HongAbstract:RATIONALE Splenic artery aneurysm (SAA) is the most common visceral artery aneurysm, while most SAAs are treated by endovascular or open procedures. PATIENT CONCERNS Here we present a case of SAA treated by laparoscopic aneurysmectomy with end-to-end anastomosis. DIAGNOSES A 40-year-old woman was incidentally found to have an asymptomatic distal SAA. CT scan revealed the SAA to be located at the hilum of the Spleen, with a maximal diameter of 2.7 cm. INTERVENTIONS To prevent sudden rupture, the patient received laparoscopic aneurysmectomy. During the operation, end-to-end anastomosis was also performed since a tortuous proximal splenic artery prevented delivery of the stent graft. OUTCOMES The patient was ambulated 12 hours after surgery and discharged 5 days later. Postoperative recovery was smooth without hemorrhage, Infarction, infection, or splenic artery thrombosis. At 10-month follow-up,no hemorrhage, aneurysm recurrence, Spleen Infarction, splenic artery stenosis, or thrombosis had occurred. LESSONS Patients with distal SAA can be treated by laparoscopic aneurysmectomy with end-to-end anastomosis to preserve the Spleen. The laparoscopic procedure is safe and feasible in the selected patients.
A Ghinoi - One of the best experts on this subject based on the ideXlab platform.
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wegener granulomatosis with Spleen Infarction case report and review of the literature
Seminars in Arthritis and Rheumatism, 2008Co-Authors: A Ghinoi, Nicolo Pipitone, Alberto Cavazza, Luigi Boiardi, Carlo SalvaraniAbstract:Objective To report a case of biopsy-verified Wegener granulomatosis (WG) with positive c-antineutrophil cytoplasmic antibodies who had evidence of Spleen Infarction and to review the relevant literature on Spleen involvement in WG. Methods Descriptive case report of 1 patient with WG complicated by Spleen Infarction and review of the relevant literature (PubMed search 1966 through February 2007). Results In our patient Spleen involvement (Infarction) was clinically silent and was incidentally detected on the caudal slides of a chest computed tomography (CT) performed to investigate pulmonary involvement. Similar cases have been reported: in the published literature reviewed, overall 18 patients have been described and other cases have been described after autopsy. Of these, 8 patients were symptomatic: generally, they complained of diffuse or left upper quadrant abdominal pain. In 15 patients, Spleen involvement was detected by ultrasound, scintigraphy, CT scan, or magnetic resonance imaging. In 1 case only was the diagnosis confirmed by biopsy (after splenectomy). Conclusions The frequency of Spleen Infarction is probably underestimated in WG since it is often clinically silent as in our patient. In addition to Spleen Infarction, WG has also been implicated in inducing Spleen hemorrhage, capsular adhesions, dysfunction, and splenomegaly. Since some of the Spleen lesions may lead to complications, a high index of suspicion should be maintained for Spleen involvement in patients with WG, particularly in the presence of abdominal symptoms.
Thomas Papo - One of the best experts on this subject based on the ideXlab platform.
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Spleen haemorrhagic Infarction and hazards of anticoagulation in wegener s granulomatosis
Annals of the Rheumatic Diseases, 1999Co-Authors: Thomas Papo, Du Le Thi Huong, Jeancharles Piette, Marc Andre, Olivier Aumaitre, Frederic Charlotte, J L KemenyAbstract:In the largest cohort published to date, no splenic involvement is described in Wegener’s granulomatosis (WG).1 We report on two patients who required splenectomy for symptomatic Spleen Infarction in the course of WG. ### CASE 1 A 42 year old man was admitted with an eight month history of arthritis and lower limb dysesthesia. Examination showed an acutely ill patient with a 39°C fever, oral ulcers, haemorrhagic gingival hyperplasia, bilateral haemorrhagic nasal discharge with crusts, diffuse necrotic purpura, neuritis, and black discoloration of some fingers and toes. The Spleen was not palpable. Silent anterior myocardial Infarction was diagnosed because of raised MB-CK levels and ST-segment increase with loss of R waves in leads V1,V2,V3 on electrocardiogram.2Antineutrophil cytoplasmic antibodies (c-ANCA) were disclosed in serum and necrotising vasculitis was shown on skin biopsy specimen.3 No antiphospholipid antibody or coagulation protein abnormality could be disclosed. Treatment consisted of intravenous administration of prednisolone, cyclophosphamide, sodium heparinate, diltiazem, dinitrosorbide and enalapril. His short-term course was uneventful. At day 14, the …