Unusual complication after laparoscopic left nephrectomy for renal tumour: a case report

Arruabarrena, Arantxa; Azagra, Juan Santiago; Wilmart, Jean Francoise; Bachner, Ioan; Manzoni, D; Goergen, Martine

doi:10.5114/wiitm.2010.14205

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…Occasionally there is a need for transfusion of blood products. Sometimes, a splenic infarct undergoes fibrosis of the malperfused segment or leads to complications such as the development of a haematoma, splenic rupture, abscess, or pseudocyst formation [30]. In such cases surgical intervention should be considered.…”

Section: Discussionmentioning

confidence: 99%

Splenic infarction as a complication of laparoscopic sleeve gastrectomy

Michalik¹,

Budziński²,

Orłowski³

et al. 2011

Videosurgery and Other Miniinvasive Techniques

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Section: Discussionmentioning

confidence: 99%

Splenic infarction as a complication of laparoscopic sleeve gastrectomy

Michalik¹,

Budziński²,

Orłowski³

et al. 2011

Videosurgery and Other Miniinvasive Techniques

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“…11 Splenic injury has been reported after nephrectomy as well: recent studies have estimated that left nephrectomies are complicated by iatrogenic splenectomy in 4.3-13.2% of cases. 12 In these instances, however, the mechanism of injury is attributed to either traction or injury from surgical instruments themselves. 12 Unlike these previously reported cases, there were no clear indications of trauma to the spleen during initial or repeat nephrectomy in our patient, as evidenced by initial postoperative imaging and the patient's initial postnephrectomy recovery.…”

Section: Discussionmentioning

confidence: 99%

“…12 In these instances, however, the mechanism of injury is attributed to either traction or injury from surgical instruments themselves. 12 Unlike these previously reported cases, there were no clear indications of trauma to the spleen during initial or repeat nephrectomy in our patient, as evidenced by initial postoperative imaging and the patient's initial postnephrectomy recovery. Occult trauma to the spleen during surgery is, however, a possible mechanism for postoperative delayed splenic injuries and should be considered.…”

Section: Discussionmentioning

confidence: 99%

Delayed Splenic Rupture after Robotic Partial Nephrectomy

Gogel¹,

Zaveri²,

Dickstein³

et al. 2020

CRSLS

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Introduction: Splenic rupture can be classified as traumatic, pathologic, or spontaneous. Spontaneous splenic rupture is rare, and accounts for only 1% of cases. Most cases of spontaneous splenic rupture involve a histopathologically abnormal spleen, but in rare cases, rupture of the spleen can occur in the absence of underlying disease or trauma. We present a case of delayed spontaneous splenic rupture in the postoperative setting following a partial nephrectomy.Case Description: A 54-y-old man presented with abdominal pain, dysuria, fever, and chills 1 week after a robotic left partial nephrectomy. An initial computed tomography scan showed no evidence of splenic injury, and he was admitted for suspected pyelonephritis. A computed tomography scan was obtained 4 d later for worsening pain and fever and revealed a 14-cm subcapsular hematoma of the spleen extending to the gastrohepatic ligament. He underwent an emergent angiogram and embolization of an actively bleeding splenic artery and inferior phrenic artery. A second embolization was required 2 d later to control ongoing bleeding. He then developed increased abdominal pain with nausea, vomiting, and continued leukocytosis secondary to a completely infarcted and necrotic spleen. A laparoscopic, hand-assisted splenectomy was performed successfully, and he was eventually discharged in stable condition. Conclusion:Spontaneous splenic rupture is extremely rare, particularly in the postoperative setting. It is possible that some of these cases are in fact secondary to occult trauma to the spleen during surgery. Prompt diagnosis and management, often with emergent splenectomy, is critical in these cases. Minimally invasive surgery is a feasible option for splenic resection in cases of spontaneous splenic rupture.

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Iatrogenic splenic injury: review of the literature and medico-legal issues

et al. 2016

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AbstractIntroductionIatrogenic splenic injury is a recognized complication in abdominal surgery. The aim of this paper is to understand the medico-legal issues of iatrogenic splenic injuries. We performed a literature review on PubMed and Scopus using iatrogenic splenic or spleen injury and iatrogenic splenic rupture as keywords. Iatrogenic splenic injury cases were identified. Most cases were related to colonoscopy, but we also identified cases related to upper gastrointestinal procedures, colonic surgery, ERCP, left nephrectomy and/or adrenalectomy, percutaneous nephrolithotomy, vascular operations involving the abdominal aorta, gynecological operation, left lung biopsy, chest drain, very rarely spinal surgery and even cardiopulmonary resuscitation. There are several surgical procedures that can lead to a splenic injury. However, from a medico-legal point of view, it is important to assess whether the cause can be attributed to a technical error of the operator rather than being an unpredictable and unpreventable complication. It is important for the medico-legal expert to have great knowledge on iatrogenic splenic injuries because it is important to evaluate every step of the first procedure performed, how a splenic injury is produced, and whether the correct treatment for the splenic injury was administered in a judgment.

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Unusual complication after laparoscopic left nephrectomy for renal tumour: a case report

Cited by 4 publications

References 12 publications

Splenic infarction as a complication of laparoscopic sleeve gastrectomy

Splenic infarction as a complication of laparoscopic sleeve gastrectomy

Delayed Splenic Rupture after Robotic Partial Nephrectomy

Iatrogenic splenic injury: review of the literature and medico-legal issues

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