ABSTRACT
BACKGROUND: Primary splenic pregnancy is a rare entity, usually treated with splenectomy. CASE PRESENTATION AND REVIEW OF THE LITERATURE: We report the first case of conservative management of splenic pregnancy with selective embolization and intramuscular methotrexate administration. Postoperative treatment was uneventful. We have further systematically reviewed the literature upon the treatment options in case of splenic pregnancy. It has been evident that most cases were treated with spleenectomy, especially in case of active hemorrhage. Spleen preservation is rarely achieved, only in cases of hemodynamically stable, uncomplicated patients. CONCLUSION: Splenic selective embolization could be a treatment option in case of uncomplicated splenic pregnancy with the benefit of splenic preservation.
Subject(s)
Abortifacient Agents, Nonsteroidal/administration & dosage , Embolization, Therapeutic/methods , Methotrexate/administration & dosage , Methotrexate/therapeutic use , Pregnancy, Abdominal/drug therapy , Spleen/surgery , Splenectomy/methods , Abdominal Pain/etiology , Adult , Angiography , Female , Hemorrhage , Humans , Pregnancy , Pregnancy, Ectopic/diagnosis , Treatment Outcome , Ultrasonography, Interventional/methodsABSTRACT
Ingested foreign bodies occur in children younger than 3 years and pass uneventfully through the gastrointestinal tract. However, multiple magnet ingestion are associated with serious complications. A 9-year old male with abdominal pain and vomiting 3 days prior to admission, underwent abdominal radiographs showing radiopaque foreign bodies. Ultrasonography (US) independently discovered one magnet floating in the jejunum. Preoperative Computed Tomography (CT) confirmed the presence of two neighbouring magnets causing obstruction and beaking of an adjacent jejunal loop. Laparotomy led to uneventful recovery of transmesenteric fistula formation following pressure necrosis in two jejunal loops. We present the first case of multiple magnet ingestion managed in our institution, where the prevalence of magnet ingestions is low due to unpopularity of magnet toys. CONCLUSION: Awareness of the potentially devastating effects of multiple magnets passing the pylorus and the contribution of different imaging modalities for the diagnosis are emphasized and discussed.
