Abstract:
:A 58-year-old female patient presented with the sudden onset of left upper quadrant pain. The physical examination revealed the presence of shock status. Abdominal computed tomography revealed splenomegaly with a huge mass inside the spleen, and massive fluid collection in the abdominal cavity. After splenic artery embolization, laparotomy was performed. The operative findings revealed intra-abdominal hemorrhage and rupture of the lower pole of the spleen. Furthermore, a palpable solid mass was observed at the splenic hilum, and distal pancreatectomy with splenectomy was performed. The macroscopic findings revealed a pancreatic tail tumor at the splenic hilum directly invading the splenic parenchyma. Microscopic examinations showed the tumor to consist of squamous cell carcinoma. Furthermore, old and new thrombi were observed inside small splenic arteries. These findings were considered to represent invasion of pancreatic adenosquamous carcinoma to the spleen, and rupture of the spleen was attributed to splenic ischemia resulting from cancer invasion and splenic vein obstruction.
journal_name
Surg Todayjournal_title
Surgery todayauthors
Asai K,Watanabe M,Matsukiyo H,Osawa A,Saito T,Hagiwara O,Nakamura Y,Okamoto Y,Saida Y,Kusachi S,Yokouchi Y,Nagao Jdoi
10.1007/s00595-010-4353-6subject
Has Abstractpub_date
2011-06-01 00:00:00pages
872-6issue
6eissn
0941-1291issn
1436-2813journal_volume
41pub_type
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