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Incarcerated inguinal hernia? No, acute pancreatitis

100%
Ramia-Angel J., Sancho E., Lozoya R., Gasz A., Santos J.
Open Medicine
|
2011
|
vol. 6
|
issue 6
770-772
EN
A 62-year-old man presented to the Emergency Department with a 2-day history of right testicular pain. The initial diagnosis was orchiepididymitis (later found to be mistaken), and intravenous antibiotic treatment was started. Twenty-four hours later, the patient had mild pain in the right inguinal area and right infra-abdominal area. We performed an inguinal ultrasound that showed an incarcerated mass of mixed echogenicity in the right inguinal area. Surgery was performed because we thought the patient had an inguinal incarcerated hernia. Two days after the surgical procedure, the patient began to have fever and erythema and pain in the back. Abdominal computed tomography (CT) showed an acute pancreatitis with a peripancreatic collection from the pancreas to right inguinal area. We have reviewed similar cases in the literature and note that, infrequently, an inguinal mass can be the first sign of mostly asymptomatic acute pancreatitis.
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Hidatidosis of the Spleen

86%
Ramia-Angel J., Gasz A., de la Plaza-Llamas R., Quinones-Sampedro J., Sancho E., Parreno J.
Polish Journal of Surgery
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2011
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vol. 83
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issue 5
271-275
EN
Hydatidosis of the spleen (SH) is an extremally rare condition.The aim of the study was to present our experience and discuss diagnostic methods and therapeutical options in cases of spleen hydatidosis.Material and methods. Between 1993 and 2008, 8 patients were diagnosed with SH, 6 of whom were operated on (4 males and 2 females). Their average age was 44.5 years (the age range 30-59 years). Four patients presented isolated SH, one had a spleen and liver hydatidosis and there was also a case of one spleen, liver and peritoneal hydatidosis.Results. The main symptom of the condition was abdominal pain and hydatidosis serology was always positive. The average hydatidisis cyst size was 13.3 cm (range: 7-18 cm). Splenectomy was performed in 5 cases and a partial cystectomy in one case. A left lateral sectionectomy was required in 1 case, a segment III subsegmentectomy was delivered in 1 case and multiple cystectomies in the case of the patient with disseminated hydatisis. In the follow-up period of the above mentioned surgical procedures no mortality among the treated patients was reported. The majority of patients did not present any symptoms of morbidity (4 patients). We registered one wound infection and one cavity abscess solved with percutaneous drainage in the patient following partial cystectomy. The hospitalisation period avaraged to 5 days (within the range of 5 to 12 days). The patients' follow-up was 98 months on average (range:19-190 months) without any traced relapse.Conclusions. Total splenectomy is the treatment of choice of SH. Other surgical techniques could be employed in special cases.
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