Orloff and Peskin (10) had suggested few criteria for labelling any case as spontaneous rupture of spleen: (i) no history of trauma; (ii) absence of any disease affecting spleen directly or indirectly; (iii) absence of perisplenic
adhesions or scarring; and (iv) presence of normal spleen, macroscopically and microscopically.
5,6) We describe a case of primary pancreatic RDD infiltrating into the peripancreatic, perinephric, and perisplenic adipose tissue, simulating malignancy.
There were white, fibrotic streaks involving the peripancreatic, perinephric, and perisplenic adipose tissues.
An ultrasound scan showed free fluid in the perihepatic and perisplenic
recesses, but no free air or air-fluid levels were seen on conventional radiographs.
It screens four areas for blood collections, namely the perisplenic
, perihepatic, pelvis and pericardium (the 4 Ps).
Hyperechoic lesions, isolated splenomegaly, perisplenic
abscess, and hepatic lesions can also be detected during abdominal ultrasound examination of splenomegaly.
In this case perisplenic
ascitic fluid was misdiagnosed as a left pleural effusion and led to unnecessary surgical opening of the left pleural space during aortic valve replacement.
Necrotic areas in the perisplenic
and periadrenal fat also stained strongly positive.
Used in blunt or penetrating torso trauma to detect free peritoneal fluid, the four-view approach is used, namely: hepato-renal space (Morrison's pouch), perisplenic
area, retro-vesical/uterine space (Douglas' pouch) and subcostal pericardial view.
A CT scan performed at the 6-month follow-up revealed recurrent soft tissue masses in the postoperative tumor bed and in other sites within the abdomen (the left subphrenic region, the lesser sac, the left renal fossa, and the perisplenic
region) (Figure 3).
Radiological case of the month: Mahender K. Narula, MBBS, MD, Rachna Madan, MBBS, MD,DNB, Om Prakash Pathania, MBBS, MS, and Rama Anand, MBBS, MD
The patient underwent splenectomy and perisplenic
lymph node biopsy.
, periaortic, and perigastric lymph nodes were grossly unremarkable.