| Peer-Reviewed

Diagnosis and Management’s Distinctive Features of an Ectopic Spleen in a Precarious Country

Received: 19 November 2019     Accepted: 9 December 2019     Published: 30 December 2019
Views:       Downloads:
Abstract

Abdominal or pelvic ectopic spleen or wandering spleen or drifting spleen is extremely rare. It is a consequence of congenital or acquired laxity of this organ’s attachment to the diaphragmatic dome, especially the suspensor ligament. The authors report a new typical case of this pathology in a 27-year-old woman, having came to consultation for painfull pelvic mass in the Joseph Ravoahangy Andrianavalona University Hospital Center in Antananarivo Madagascar, which is a precarious country. The positive diagnostic of this pathology and its surgical approach are often limited by the locally available tools and the financial accessibility of the patient to them. Ultrasonography and Computed Tomography imaging show the emptiness of the splenic lodge, localize the spleen with its size, and precise its vascularisation’s pathway. The symptoms are naturally latent until complication appears. Surgery is more formally indicated in case of complication or because of the risk of confusion with parasitic splenomegaly which has a high prevalence in a tropical country as Madagascar. Splenopexy can exposes to more recurrences, systemacic splenectomy can expose to risks of more postoperative infection even it is more practiced. As proposed in the literature, laparoscopy could and should be developed because it does not have any eventful recovery.

Published in European Journal of Clinical and Biomedical Sciences (Volume 5, Issue 6)
DOI 10.11648/j.ejcbs.20190506.14
Page(s) 89-91
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Diagnostic Imaging, Ectopic Spleen, Wandering Spleen, Surgical Approach, Precarious Country

References
[1] Hirsch NP, Murphy A, Radcliffe JJ. Neurofibromatosis: clinical presentations and anaesthetic implications. Br J Anaesth. 2001; 86: 555-564.
[2] Crowe FW, Schull WJ, Neel JV. A Clinical, Pathological, and Genetic Study of Multiple Neurofibromatosis. Springfield, IL: Charles C. Thomas, 1956.
[3] Fox CJ, Tomaijian S, Kaye AJ, et al. Perioperative management of neurofibromatosis type 1. Ochsner J 2012; 12: 111-121.
[4] McSwain JR, Doty JW, Wilson SW. Regional anesthesia in patients with pre-existing neurologic disease. Curr Opin Anesthesiol 2014; 27: 538-543.
[5] Forero M, Adhikary SD, Lopez H. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med 2016; 41: 621-627.
[6] Chin KJ, Adhikary S, Sarwani N, et al. The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. Anaesthesia 2017; 72: 1-8.
[7] Chin KJ, Malhas L, Perlas A. The Erector Spinae Plane Block Provides Visceral Abdominal Analgesia in Bariatric Surgery. Reg Anesth Pain Med 2017; 42: 372-376.
[8] Freise H, Van Aken HK. Risks and Benefits of thoracic epidural anaesthesia. British Journal of Anaesthesia. 2011; 107 (6): 859-868.
[9] Block BM, Liu SS, Rowlingson AJ, et al. Efficacy of Postoperative Epidural Analgesia: A Metanalysis. JAMA 2003; 290: 2455-2463.
[10] Williams UU, Zavala AM, Van Meter A, et al. Unanticipated Compression of the Trachea in a 5-month-old Undergoing an MRI for Evaluation of Neurofibromatosis. A&A Case Reports 2017; 8: 1-3.
[11] Spiegel JE, Hapgood A, Hess PE. Epidural anesthesia in a parturient with neurofibromatosis type 2 undergoing cesarean section. International Journal of Obstetric Anesthesia. 2005; 14: 336-339.
[12] Esler MD, Durbridge J, Kirby S. Epidural haematoma after dural puncture in a parturient with neurofibromatosis. Br J Anaesth 2001; 87: 932-934.
Cite This Article
  • APA Style

    Solonirina Davidà Rakotomen, Narindra Njarasoa Mihaja Razafimanjato, Kanto Adrienne Razafindraibe, Auberlin Felantsoa Rakototiana, Hery Nirina Rakoto-Ratsimba. (2019). Diagnosis and Management’s Distinctive Features of an Ectopic Spleen in a Precarious Country. European Journal of Clinical and Biomedical Sciences, 5(6), 89-91. https://doi.org/10.11648/j.ejcbs.20190506.14

    Copy | Download

    ACS Style

    Solonirina Davidà Rakotomen; Narindra Njarasoa Mihaja Razafimanjato; Kanto Adrienne Razafindraibe; Auberlin Felantsoa Rakototiana; Hery Nirina Rakoto-Ratsimba. Diagnosis and Management’s Distinctive Features of an Ectopic Spleen in a Precarious Country. Eur. J. Clin. Biomed. Sci. 2019, 5(6), 89-91. doi: 10.11648/j.ejcbs.20190506.14

    Copy | Download

    AMA Style

    Solonirina Davidà Rakotomen, Narindra Njarasoa Mihaja Razafimanjato, Kanto Adrienne Razafindraibe, Auberlin Felantsoa Rakototiana, Hery Nirina Rakoto-Ratsimba. Diagnosis and Management’s Distinctive Features of an Ectopic Spleen in a Precarious Country. Eur J Clin Biomed Sci. 2019;5(6):89-91. doi: 10.11648/j.ejcbs.20190506.14

    Copy | Download

  • @article{10.11648/j.ejcbs.20190506.14,
      author = {Solonirina Davidà Rakotomen and Narindra Njarasoa Mihaja Razafimanjato and Kanto Adrienne Razafindraibe and Auberlin Felantsoa Rakototiana and Hery Nirina Rakoto-Ratsimba},
      title = {Diagnosis and Management’s Distinctive Features of an Ectopic Spleen in a Precarious Country},
      journal = {European Journal of Clinical and Biomedical Sciences},
      volume = {5},
      number = {6},
      pages = {89-91},
      doi = {10.11648/j.ejcbs.20190506.14},
      url = {https://doi.org/10.11648/j.ejcbs.20190506.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20190506.14},
      abstract = {Abdominal or pelvic ectopic spleen or wandering spleen or drifting spleen is extremely rare. It is a consequence of congenital or acquired laxity of this organ’s attachment to the diaphragmatic dome, especially the suspensor ligament. The authors report a new typical case of this pathology in a 27-year-old woman, having came to consultation for painfull pelvic mass in the Joseph Ravoahangy Andrianavalona University Hospital Center in Antananarivo Madagascar, which is a precarious country. The positive diagnostic of this pathology and its surgical approach are often limited by the locally available tools and the financial accessibility of the patient to them. Ultrasonography and Computed Tomography imaging show the emptiness of the splenic lodge, localize the spleen with its size, and precise its vascularisation’s pathway. The symptoms are naturally latent until complication appears. Surgery is more formally indicated in case of complication or because of the risk of confusion with parasitic splenomegaly which has a high prevalence in a tropical country as Madagascar. Splenopexy can exposes to more recurrences, systemacic splenectomy can expose to risks of more postoperative infection even it is more practiced. As proposed in the literature, laparoscopy could and should be developed because it does not have any eventful recovery.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Diagnosis and Management’s Distinctive Features of an Ectopic Spleen in a Precarious Country
    AU  - Solonirina Davidà Rakotomen
    AU  - Narindra Njarasoa Mihaja Razafimanjato
    AU  - Kanto Adrienne Razafindraibe
    AU  - Auberlin Felantsoa Rakototiana
    AU  - Hery Nirina Rakoto-Ratsimba
    Y1  - 2019/12/30
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ejcbs.20190506.14
    DO  - 10.11648/j.ejcbs.20190506.14
    T2  - European Journal of Clinical and Biomedical Sciences
    JF  - European Journal of Clinical and Biomedical Sciences
    JO  - European Journal of Clinical and Biomedical Sciences
    SP  - 89
    EP  - 91
    PB  - Science Publishing Group
    SN  - 2575-5005
    UR  - https://doi.org/10.11648/j.ejcbs.20190506.14
    AB  - Abdominal or pelvic ectopic spleen or wandering spleen or drifting spleen is extremely rare. It is a consequence of congenital or acquired laxity of this organ’s attachment to the diaphragmatic dome, especially the suspensor ligament. The authors report a new typical case of this pathology in a 27-year-old woman, having came to consultation for painfull pelvic mass in the Joseph Ravoahangy Andrianavalona University Hospital Center in Antananarivo Madagascar, which is a precarious country. The positive diagnostic of this pathology and its surgical approach are often limited by the locally available tools and the financial accessibility of the patient to them. Ultrasonography and Computed Tomography imaging show the emptiness of the splenic lodge, localize the spleen with its size, and precise its vascularisation’s pathway. The symptoms are naturally latent until complication appears. Surgery is more formally indicated in case of complication or because of the risk of confusion with parasitic splenomegaly which has a high prevalence in a tropical country as Madagascar. Splenopexy can exposes to more recurrences, systemacic splenectomy can expose to risks of more postoperative infection even it is more practiced. As proposed in the literature, laparoscopy could and should be developed because it does not have any eventful recovery.
    VL  - 5
    IS  - 6
    ER  - 

    Copy | Download

Author Information
  • Department of Visceral Surgery, Joseph Ravoahangy Andrianavalona University Hospital Center, Antananarivo, Madagascar

  • Department of Thoracic Surgery, Joseph Ravoahangy Andrianavalona University Hospital Center, Antananarivo, Madagascar

  • Department of Medical Imaging, Joseph Ravoahangy Andrianavalona University Hospital Center, Antananarivo, Madagascar

  • Department of Urology, Joseph Ravoahangy Andrianavalona University Hospital Center, Antananarivo, Madagascar

  • Department of Visceral Surgery, Joseph Ravoahangy Andrianavalona University Hospital Center, Antananarivo, Madagascar

  • Sections