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A cause for conversion of laparoscopic splenectomy: splenic candidiasis
Rosario Vecchio1, Emma Cacciola, Marcello di Martino
1Department of Surgery, University of Catania, Vittorio Emanuele Hospital, Catania, Italy. rvecchio@mbox.unict.it
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|February 20, 2003
Summary
Laparoscopic splenectomy (LS) is a preferred spleen removal method, but perisplenitis presents challenges. This case highlights the difficulty of LS in splenic candidiasis due to adhesions, necessitating conversion to open surgery.
Area of Science:
- Surgical Oncology
- Mycology
- Gastroenterology
Background:
- Laparoscopic splenectomy (LS) is the standard surgical approach for various splenic conditions.
- Perisplenitis, inflammation of the splenic capsule, is a relative contraindication for LS.
- Splenic candidiasis is a rare fungal infection localized to the spleen.
Observation:
- A rare case of isolated splenic candidiasis was treated with laparoscopic splenectomy.
- Dense adhesions between the spleen and diaphragm due to perisplenitis were encountered.
- These adhesions posed significant technical challenges during the laparoscopic procedure.
Findings:
- The laparoscopic splenectomy (LS) was converted to an open splenectomy due to severe adhesions.
- The open procedure allowed for safe completion of the splenectomy.
- This case underscores the technical difficulties and risks associated with LS in the presence of perisplenitis.
Implications:
- Splenectomy is effective for treating localized splenic fungal infections.
- Laparoscopic splenectomy in cases of perisplenitis is technically demanding and carries risks.
- Careful pre-operative assessment and surgical planning are crucial for managing complex splenic cases.