Laparoscopic gastric band removal complicated by splenosis

Nicolas, G; Schoucair, Ramy; Shimlati, Rasha; Rached, Linda; Khoury, George

doi:10.1002/ccr3.633

Cited by 3 publications

(5 citation statements)

References 11 publications

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“…5 During the operation, they detected many foci of splenosis, for example, at the gall bladder, the stomach, the liver, and the diaphragm. 5 Because of the high risk of massive bleeding through erosion of the gastric band into the splenic tissue, the gastric band had to be removed and the surgery terminated due to the difficult anatomic situation. 5 Another pitfall was described by Sorensen et al, which shows the consequences of misdiagnosis for the individual patient and strongly emphasizes the importance of awareness.…”

Section: Discussionmentioning

confidence: 99%

“…5 Because of the high risk of massive bleeding through erosion of the gastric band into the splenic tissue, the gastric band had to be removed and the surgery terminated due to the difficult anatomic situation. 5 Another pitfall was described by Sorensen et al, which shows the consequences of misdiagnosis for the individual patient and strongly emphasizes the importance of awareness. 6 In their case, curative surgery for a patient with carcinoma of the Papilla vateri was denied because of peritoneal carcinosis diagnosed in a CT scan.…”

Section: Discussionmentioning

confidence: 99%

“…Nicolas et al for example presented a case of a 30-year-old patient, who showed excessive weight gain after gastric band surgery and was therefore indicated for conversion into a gastric sleeve. 5 During the operation, they detected many foci of splenosis, for example, at the gall bladder, the stomach, the liver, and the diaphragm. 5 Because of the high risk of massive bleeding through erosion of the gastric band into the splenic tissue, the gastric band had to be removed and the surgery terminated due to the difficult anatomic situation.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Coincidence of Intra-Abdominal Splenosis in a Patient with Advanced Ovarian Cancer: Case Report and Review of the Literature

et al. 2021

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Splenosis is a rare disease, which is often discovered incidentally years after surgical procedures on the spleen or traumatic splenic lesions. Through injury of the splenic capsule, splenic cells are able to spread and autoimplant in a fashion similar to the process of metastatic cancer. Here we present the case of a 62-year-old female patient with a palpable tumor of the lower abdomen. Her medical history was unremarkable, except for splenectomy after traumatic splenic lesion in her childhood. Clinical examination and diagnostic imaging raised the suspicion of advanced ovarian cancer, which was further substantiated by the typical presentation of adnexal masses and disseminated peritoneal metastases during the following staging laparotomy. Surprisingly, we also found peritoneal implants macroscopically similar to splenic tissue. Microscopic examination of tissue specimens by intrasurgical frozen section confirmed the diagnosis of intra-abdominal splenosis. The patient then underwent cytoreductive surgery with complete resection of all cancer manifestations, sparing the remaining foci of splenosis to avoid further morbidity. This case demonstrates the rare coincidence of intra-abdominal carcinoma and splenosis, which could lead to intraoperative difficulties by misinterpreting benign splenic tissue. Therefore, splenosis should be considered in patients with medical history of splenic lesions and further diagnostic imaging like Tc-99m-tagged heat-damaged RBC scan could be used for presurgical distinguishing between tumor spread in the abdominal cavity and disseminated splenosis. The presented case report should not only raise awareness for the rare disease splenosis, but also emphasize the need to consider the possibility of simultaneous incidence of benign and malignant intra-abdominal lesions, as to our knowledge this is the first published case of simultaneous peritoneal carcinomatosis and splenosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Coincidence of Intra-Abdominal Splenosis in a Patient with Advanced Ovarian Cancer: Case Report and Review of the Literature

et al. 2021

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“…However, despite advantages over open surgery, the rarity of splenosis has limited a more thorough evaluation of its safety and effectiveness. Our evaluation of previous cases in PubMed, Ovid, and other databases found only 15 reports of laparoscopic ectopic splenectomy, while laparoscopic gastric ectopic splenectomy was rarely reported[ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Splenosis masquerading as gastric stromal tumor: A case report

Zheng¹,

Xu²,

Sun³

2021

WJCC

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BACKGROUND Splenosis is a rare benign disease that often disguises itself as a malignant tumor. There are few articles providing a comprehensive description of splenosis, especially cases located in the stomach being treated by laparoscopic surgery. CASE SUMMARY A 44-year-old man presented with recurrent upper abdominal pain for more than half a year. The patient had splenic rupture caused by trauma more than 10 years ago and underwent splenectomy. An abdominal contrast-enhanced computed tomography scan revealed an irregular soft tissue density. Gastroscopy revealed an approximately 3.0 cm × 3.0 cm mucosal eminence at the posterior wall of the upper segment of the gastric body. Biopsy was not performed since the lesion was found under the mucosa and the gastric mucosa appeared normal. According to these findings, a diagnosis of gastric stromal tumor was made, although a definitive differential diagnosis was not known before surgery. When laparoscopic resection of the gastric stromal tumor was performed, an astonishing finding was made when postoperative pathology showed that the lesion comprised typical spleen tissue. CONCLUSION This case highlights the strong similarities between splenosis and malignant tumors. A detailed medical history combined with various effective auxiliary examinations can help improve differential diagnosis.

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Gastric fundus splenosis with hemangioma masquerading as a gastrointestinal stromal tumor in a patient with schistosomiasis and cirrhosis who underwent splenectomy

Guan¹,

Li²,

Wang³

et al. 2018

Medicine

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Rationale:Splenosis is the heterotopic auto-transplantation of the splenic tissues. Gastric splenosis in a rare location mimics a gastrointestinal stromal tumor (GIST). Gastric splenosis with hemangioma has not been reported throughout the literature.Patient concerns:We report a case of a 74-year-old schistosomiasis cirrhosis splenectomy woman diagnosed with gastric fundus mass. Preoperative computed tomography and endoscopic ultrasonography revealed findings suggestive of a GIST.Diagnoses:The mass located in the gastric fundus muscularis propria, measuring 3.9 × 2.8 × 2.4 cm with a dark red color, was removed by surgery. In the mass, a 1 × 1-cm red-purple nodule was also found. On microscopic examination, a well-formed splenic tissue divided into two compartments–white pulp and red pulp–separated by an ill-defined interphase known as the marginal zone. However, a nodule in the heterotopic spleen was mainly composed of larger thin-walled muscular vessels. The final diagnosis was gastric splenosis with hemangioma.Interventions:After discussion in a multidisciplinary conference, the patient was considered for a GIST resection under gastroscopy. In the process of peeling, the surface of the mucosal, submucosal, muscle layers and the tumor surface were diffusely oozing. The effect of electrocoagulation and hemostasis was extremely poor. Therefore, endoscopic surgery was arrested. After dealing with the patient's family, a combination of laparoscopic-gastroscope double-mirror surgery was decided in accordance with the principle of minimally invasive surgery to preserve the stomach. Owing to several adhesions and concealed the location of tumor, we stopped the double-mirror combination surgery plan. Considering the great possibility of a malignant GIST, we still decided to continue the traditional surgical resection. The tumor was then removed via surgeryOutcomes:The patient was favorable with healing and discharged on postoperative day 10.Lessons:Gastric splenosis with an associated hemangioma is the first well-documented case. Its pathogenesis may be direct implantation. Appropriate medical history taking and Tc-99 m heat-denatured RBC spleen scintigraphy (Tc-99MHDRS) are valuable for its diagnosis; however, pathology is the gold standard. Surgery is a reasonable treatment for gastric splenosis with hemangioma.

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Laparoscopic gastric band removal complicated by splenosis

Cited by 3 publications

References 11 publications

Coincidence of Intra-Abdominal Splenosis in a Patient with Advanced Ovarian Cancer: Case Report and Review of the Literature

Coincidence of Intra-Abdominal Splenosis in a Patient with Advanced Ovarian Cancer: Case Report and Review of the Literature

Splenosis masquerading as gastric stromal tumor: A case report

Gastric fundus splenosis with hemangioma masquerading as a gastrointestinal stromal tumor in a patient with schistosomiasis and cirrhosis who underwent splenectomy

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