title: Splenic infarction - A rare cause of acute abdominal pain following gastric surgery: A case series.
abstract: BACKGROUND
  The dissection of splenic hilar lymph nodes in gastric cancer surgery is indispensable for treating gastric cancers located in the proximal third of the stomach. Splenic vascular injury is a matter of debate resulting on time or delayed splenectomy. We aimed to share our experience and plausible mechanisms causing this complication in two case reports.
  
  
  METHODS
  Two male patients with gastric cancer were diagnosed with acute splenic infarction following gastric surgery in the early postoperative period. Both underwent emergent exploratory laparotomy. Splenectomy was performed due to splenic infarction.
  
  
  CONCLUSIONS
  Because we observed this rare complication in recent patients whose surgery was performed using vessel-sealing device for splenic hilar dissection, we suggested that extensive mobilization of the surrounding tissues of splenic vascular structures hilum using the vessel sealer could be the reason.
  
  
  CONCLUSIONS
  In case of acute abdominal pain radiating to left shoulder, splenic complications should be taken into consideration in gastric cancer patients performed radical gastrectomy. Meticulous dissection of splenic hilar lymph nodes should be carried out to avoid any splenic vascular injury.
authors.affiliation: Sisli Etfal Training and Research Hospital, Department of General Surgery, Istanbul, Turkey. Electronic address: drpinaryazici@gmail.com.
authors.forename: Pinar
authors.initials: P
authors.lastname: Yazici
authors.affiliation: Sisli Etfal Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Kaya
authors.affiliation: Sisli Etfal Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
authors.forename: Gurhan
authors.initials: G
authors.lastname: Isil
authors.affiliation: Sisli Etfal Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Bozkurt
authors.affiliation: Sisli Etfal Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Mihmanli
keywords: D2 lymphadenectomy; Gastrectomy for cancer; Postoperative complication; Splenic hilar lymphadenectomy; Splenic infarction
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