Asymptomatic partial splenic infarction in laparoscopic floppy Nissen fundoplication and brief literature review.
Short gastric vessels are divided during the laparoscopic Nissen fundoplication resulting in splenic infarct in some cases. We report a case of laparoscopic floppy Nissen fundoplication with splenic infarct that was recognized during the procedure and provide a brief literature review. The patient underwent a laparoscopic floppy Nissen fundoplication. We observed a partial infarction of the spleen. She reported no pain. A follow-up computed tomography scan showed an infarct, and a 3-month abdominal ultrasound showed complete resolution. Peripheral splenic arterial branches have very little collateral circulation. When these vessels are occluded or injured, an area of infarction will occur immediately. Management strategies included a trial of conservative management and splenectomy for persistent symptoms or complications resulting from splenic infarct. In conclusion, we believe that the real incidence is probably much higher because many cases of SI may have gone undiagnosed during or following an operation, because some patients are asymptomatic. We propose to check spleen carefully for the possibility of splenic infarct.
Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey.
Mehmet
M
Odabasi
Haci Hasan
HH
Abuoglu
Cem
C
Arslan
Emre
E
Gunay
Mehmet Kamil
MK
Yildiz
Cengiz
C
Eris
Erkan
E
Ozkan
Ali
A
Aktekin
Tolga
T
Muftuoglu
D000328:Adult; D005260:Female; D018662:Fundoplication / Q000009:adverse effects* / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D013154:Spleen / Q000098:blood supply*; D013159:Splenic Infarction / Q000175:diagnosis* / Q000209:etiology; D013270:Stomach / Q000098:blood supply / Q000601:surgery; D016896:Treatment Outcome
Laparoscopic Nissen fundoplication; Short gastric vessels; Splenic infarction