Intrapancreatic accessory spleen

Santos, Marcelo F.; Rezende, Aline Pacheco de; Filho, Paulo Vicente dos Santos; Gonçalves, José Eduardo; Beraldo, Fernando Bray; Sampaio, Adriano Pereira

doi:10.1590/s1679-45082017rc3942

Cited by 10 publications

(8 citation statements)

References 8 publications

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“…As causas que podem estar envolvidas são anormalidades congênitas, assim como rupturas ou frouxidão dos ligamentos gastroesplênicos ou esplenocólicos [9,24]. O baço acessório é caracterizado por um defeito na formação embrionária do tecido esplênico [22]. Estão frequentemente associados com outras malformações congênitas [5].…”

Section: Discussionunclassified

“…Sendo assim, conclui-se que no caso estudado seja de um baço acessório pelas características macroscópicas visualizadas no procedimento cirúrgico, além das características que definem as duas estruturas [17]. A funcionalidade desse órgão não é bem elucidada, acredita-se que tenha a capacidade de realizar eritrofagocitose, retirando os eritrócitos envelhecidos da corrente sanguínea [22]. Alguns autores relatam que os baços acessórios sofrem hipertrofia compensatória pós-esplenectomia participando da função imunológica do animal [14].…”

Section: Discussionunclassified

“…É considerada uma emergência cirúrgica, sendo necessária uma intervenção precoce para minimizar os riscos de complicações [13,24]. O baço acessório consiste em uma fração de tecido esplênico independente do órgão principal, causado por um defeito no desenvolvimento embrionário do baço [14,22]. Pode ser de origem congênita, sendo um achado relativamente comum em cães [3,7,25].…”

Section: Introductionunclassified

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Primary Splenic Torsion Associated with Accessory Spleen in a Dog

Santos

Gomes

Camargo

et al. 2019

Acta Scientiae. Vet.

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Background: Primary splenic torsion occurs when there is a splenic vascular pedicle rotation without association of other diseases, as the Gastric Dilatation Volvulus (GDV). Accessory spleen consists in a splenic tissue fraction independent from main organ, caused by a spleen defect in the embryonic development, most remaining asymptomatic and discovered incidentally. They have their own blood supply, which is usually from a branch of the splenic artery. Present report represents a primary splenic torsion with the accessory spleen finding in a dog. Case: A 7-year-old female mongrel was referred to Veterinary Hospital of Universidade Federal do Rio Grande do Sul, showing pain and firm consistency in the left abdominal region, prostration and inappetence four days before the medical appointment. At the clinical examination, the patient was alert, 7% dehydration, hypocorous mucous membranes, without alteration in lymph nodes, left abdominal pain. Laboratory tests, chest radiographic and abdominal ultrasound was requested. Two images compatible with splenic image were visualized, one with a regular structure without vascularization suggesting splenic torsion and another with homogeneous parenchyma and echogenicity of the normal spleen, with vascularization signal. The animal was referred to the surgical procedure and the anesthetic induction protocol with propofol (6 mg/kg -1 ) and ketamine hydrochloride (2 mg/kg -1 ) and maintenance with total intravenous anesthesia with propofol (0.2-0.4 mg/kg -1 / min) and lidocaine (2 mg/kg -1 ), in a semi-closed loop and spontaneous ventilation. The pre-retro-umbilical incision in the ventral midline was performed, and the exploratory celiotomy was done. During the cavity exploring, a small amount of free fluid and a structure compatible with the spleen were observed. It was noted that the splenic vascular pedicle was twisted around its axis and the gastroesplenic and splenocolic ligaments were also involved. The stomach maintained its position, size and vascularization. Thus, an isolated or primary splenic torsion was characterized. The exploratory laparotomy was recommended, and the total splenectomy was the treatment of choice. The accessory spleen did not demonstrate vascular damage; therefore, was advocated the zeal in handling to preserve your integrity. Discussion: Isolated splenic torsion is a rare occurrence in dogs. A retrospective study was performed with 60 dogs presenting with non-traumatic hemoperitoneum, in which only three cases presented splenic torsion. Usually, twisting occurs in large or giant breed dogs with deep chest conformation. The etiology of splenic torsion is not well established. Primary splenic torsion is considered emergency surgery, and the prognosis is considered favorable. The literature shows no relation between the presence of the accessory spleen and the occurrence of primary splenic torsion, but both occur due to congenital defects, both of which may be correlated in this case. The accessory spleen is characterized by a defect in the embryo...

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Section: Discussionunclassified

Section: Introductionunclassified

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Primary Splenic Torsion Associated with Accessory Spleen in a Dog

Santos

Gomes

Camargo

et al. 2019

Acta Scientiae. Vet.

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“…Therefore, a physiological accumulation of 68Ga-DOTA-TOC is commonly observed in splenic tissue. [20] 18F-prostate-specific membrane antigen (PSMA) PET/CT scanning can detect the IPAS as it possesses several advantageous physical features. This includes a longer half-life and larger allowable mean injected activity.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic spleen-preserving pancreatic resection for intrapancreatic accessory spleen

Liu

Chen

et al. 2019

Medicine

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Introduction: Intrapancreatic accessory spleen (IPAS) has been rarely noted radiologically because the spatial resolution of conventional images was low. The infrequent presence of the accessory spleen in the pancreatic tissue could lead to inappropriate diagnosis, thereby necessitating a therapeutic approach. The present study reported such cases and summarized the available imaging findings to reduce unnecessary invasive surgeries. Patient concerns: The patient's complaint was “a pancreatic mass was found for half a month.” Diagnosis: IPAS was eventually diagnosed by pathology. Interventions: Laparoscopic spleen-preserving pancreatic resection. Outcomes: Postoperative course was uneventful and the patient was discharged from our hospital after 10 days. Conclusions: When an asymptomatic pancreatic mass is detected, the diagnosis of IPAS should not be excluded, especially if the lesion has the same imaging features as the spleen. As a definite diagnosis of IPAS is difficult by a single examination, multiple techniques might be essential.

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“…Não foram identificados fatores preditores de REDT e o aumento isolado do baço após o trauma é um possível sinal de ruptura tardia. (12,13,14) O baço acessório raramente apresenta relevância clínica ou patológica e normalmente passa assintomático e não diagnosticado. No caso apresentado o paciente foi submetido a ressecção cirúrgica por laparotomia exploratória devido a um trauma, sendo identificado então a presença de baço acessório.…”

Section: Introductionunclassified