Cua Dong General Hospital successfully performed surgery on a patient with splenic infarction and necrosis due to torsion.
(Baonghean.vn) - Recently, Cua Dong General Hospital successfully diagnosed and performed a splenectomy on patient Nguyen Thi T. (17 years old), residing in Mai Phu, Loc Ha, Ha Tinh, due to a rare disease of ectopic spleen torsion, causing splenic infarction and necrosis.
Patient T. was found to have an ectopic spleen in the left iliac fossa for many years. For more than a week now, after strenuous exercise, the patient has had continuous dull pain, accompanied by nausea, vomiting, fatigue, pain when pressed and a hard mass in the left iliac fossa. The patient went to a hospital in the province for examination and treatment. The patient was diagnosed with intussusception, treated for 4 days with less pain, and was sent home for monitoring. However, at home, the patient experienced abdominal pain and a lump in the lower abdomen accompanied by fever, so he was admitted to Cua Dong General Hospital for treatment.
 |
| Image of a patient's spleen with multiple twists and necrosis. Photo: Cao Phuong |
After examination, the doctors of the General Surgery Department performed blood tests, CT scans and ultrasounds on the patient, and discovered that the patient T.'s spleen was abnormally enlarged and misplaced (the length of the spleen was 127 mm), located in the left pelvis, and the splenic vascular bundle was twisted many times, causing splenic infarction. After consultation, the patient was scheduled for emergency surgery.
 |
| The team of doctors at Cua Dong General Hospital successfully performed a spleen removal surgery on patient Nguyen Thi T. Photo: Cao Phuong |
The surgical team performed emergency surgery on the patient. During the surgery, the doctors discovered that the spleen was enlarged in the pelvis, and that the spleen was twisted in many purple-black circles and could not be preserved, so they decided to remove the patient's spleen. After more than 1 hour of surgery, the patient had a favorable development and was discharged after 5 days of treatment.
 |
| Necrotic spleen specimen after being surgically removed from the patient's body. Photo: Cao Phuong |
MSc. Doctor Thai Doan Cong - Head of General Surgery Department, Deputy Director of Cua Dong General Hospital - who directly performed surgery on patient T. said: Ectopic spleen is a rare disease, characterized by abnormal position of the spleen in the lower abdomen or pelvis due to weakness or absence of ligaments. Clinical features of ectopic spleen are not specific and range from chronic to acute abdominal pain due to torsion of the splenic pedicle. Ectopic spleen accounts for <0.25% of splenectomy cases, occurring more frequently in women aged 20 - 40 and children < 10 years old. The treatment of choice for ectopic spleen is surgical fixation of the spleen, surgical removal of the spleen is only in cases of splenic torsion, infarction, splenic thrombosis and suspected malignancy.
As in the case of patient T., the spleen was abnormally enlarged and misplaced in the pelvis, the splenic vascular bundle was twisted many times causing splenic infarction and necrosis. If not operated on promptly, the patient's life would be in danger.
Master, Doctor Thai Doan Cong recommends: If a patient has discovered that the spleen is in an abnormal position and suddenly has a sudden abdominal pain that then gradually decreases or becomes severe, causes vomiting, and bloating, then there is a risk of spleen torsion. At this time, family members should take the patient to a medical facility for timely examination and treatment./.
