A new technique for fixation of a mobile spleen is described. It offers the advantages of a minimally risky procedure that very effectively keeps a mobile spleen in its bed without foreign materials and is feasible even when the gastrosplenic ligament is absent and the splenic vessels are uncovered. Our "button and hole" sutureless splenopexy was performed in six patients from 1979 to 1995. Three had a gastric volvulus (GV) and an extremely mobile spleen; one of these also had a diaphragmatic eventration. Another three had torsion of the spleen; in one it occurred 9 months after repair of a diaphragmatic hernia. We achieved good results with splenopexy as the sole operation in two cases where a wandering spleen produced a GV.
We report on 2 newborns with adrenal cysts who were treated successfully with an operation. One patient had been well after birth with no adrenal insufficiency. However, 2 large and 2 small cysts were found, all of which were attached to the adrenal gland without a clear vascular stalk. The other patient had adrenal cortical insufficiency. His mother had had gestational diabetes and hypertension during pregnancy. The adrenal cyst was partially resected. Both patients were in good condition 5 years postoperatively.
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