Pelvic splenosis implanted in Douglas pouch mimics pseudo-endometriosis symptoms: a case report study
Azamosadat Mousavi1, Farzaneh Golfam2, Aghdas Ebadi Jamkhane3
1Department of Gynecology Oncology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Introduction And Importance:
Pelvic splenosis is characterized by the autotransplantation of spleen fragments following tissue rupture. Since the fragments are mostly implanted into the Douglas pouch, endometriosis-like symptoms are developed, clinically. Thus, this case report demonstrated a successful surgical procedure for pelvic splenosis management.
Clinical Presentation:
A 43-year-old woman with chronic pelvic pain was admitted to hospital. Medical history showed a car accident (at the age of 5 years) and severe spleen trauma followed by splenectomy. Patient assessment and sonography procedure revealed the presence of retrouterine mass with primary endometriosis diagnosis. Exploratory laparotomy was applied and total hysterectomy and bilateral salpingo-oophorectomy were conducted. The mass was excised and histopathologic assessment revealed the splenosis with pseudo-endometriosis symptoms.
Clinical Discussion:
Severe spleen trauma followed by rupture can potentially lead to displaced splenic fragments. Since these tissue segments implant in Douglas pouch, anatomical relations can lead to chronic pelvic symptoms misdiagnosed with endometriosis.
Conclusion:
Thus, to prevent misdiagnosis and ineffective interventions, it is recommended for clinicians to consider the presence of pelvic splenosis in women with a history of acute splenic trauma and subsequent splenectomy.
Related Concept Videos
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.