technetium-tc-99m-sulfur-colloid and Abdominal-Injuries

Splenosis is defined as the autotransplantation of splenic tissue to abnormal locations after splenic injury. Although abdominal splenosis is the most common form and is usually discovered at laparotomy, thoracic splenosis is less common and occurs as an asymptomatic peripheral pulmonary nodule, incidentally discovered on a routine chest radiograph. Given the long interval between the initial trauma and its discovery, thoracic splenosis is rarely considered in the differential diagnosis of left-sided, pleural-based pulmonary nodules or masses. The diagnosis is often a result of surgery. The authors report an additional case of thoracic splenosis, review the literature, and discuss nonsurgical diagnostic methods.

Topics: Abdominal Injuries; Humans; Male; Middle Aged; Radiography, Thoracic; Radionuclide Imaging; Radiopharmaceuticals; Splenosis; Technetium Tc 99m Sulfur Colloid; Thorax; Tomography, X-Ray Computed; Wounds, Gunshot

Topics: Abdominal Injuries; Erythrocytes; Hemobilia; Humans; Kidney; Liver; Postoperative Complications; Spleen; Splenectomy; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed; Tomography, X-Ray Computed; Ultrasonography; Wounds, Nonpenetrating

Topics: Abdominal Injuries; Adolescent; Adult; beta-Thalassemia; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Purpura, Thrombocytopenic, Idiopathic; Splenectomy; Splenosis; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Abdominal Injuries; Aged; Hernia, Diaphragmatic; Humans; Hypertrophy; Imino Acids; Liver; Male; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Disofenin; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Clinical and laboratory studies have documented high susceptibility to pneumococcal infection in asplenic humans and animals. Splenic autotransplantation has been suggested as a method of preserving function. Autotransplantation of irreparably damaged spleens in humans preserved splenic functions. Ten patients operated on for blunt abdominal trauma required unavoidable splenectomy. In each, autotransplantation of the removed spleen (roughly 50 g) was performed. Postoperative studies of splenic functions revealed disappearance of Howell-Jolly bodies from peripheral blood. Levels of IgM, which were initially significantly depressed, returned to normal and there were normal technetium Tc 99m sulfur colloid scans ten weeks after surgery. All patients are alive and healthy. Our data suggest that autotransplantation of spleen is a safe alternative method for preserving splenic function when total splenectomy is mandatory for hemostasis.

Topics: Abdominal Injuries; Adolescent; Adult; Child; Erythrocyte Inclusions; Female; Follow-Up Studies; Humans; Immunoglobulin M; Male; Spleen; Splenectomy; Technetium Tc 99m Sulfur Colloid; Transplantation, Autologous; Wounds, Nonpenetrating

Topics: Abdominal Injuries; Aged; Erythrocyte Inclusions; Erythrocytes, Abnormal; Female; Humans; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid

Topics: Abdominal Injuries; Adult; Humans; Male; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid; Wounds, Nonpenetrating

The diagnosis of delayed rupture of the spleen is demonstrated and discussed by presenting a case in which the patient had significant thoracoabdominal trauma with an initially normal liver/spleen scintigram and benign hospital course. Twenty-three days after the trauma, the patient developed an acute abdominal crisis that brought him to the emergency room where an emergency ultrasound revealed hemoperitoneum and a subcapsular hematoma. At laparotomy, a splenic rupture was found. A splenectomy was not performed. Postoperative liver/spleen scintigram showed a persistent defect which was not present on the initial liver/spleen scintigram.

Topics: Abdominal Injuries; Adult; Humans; Male; Radionuclide Imaging; Spleen; Splenic Rupture; Technetium Tc 99m Sulfur Colloid; Thoracic Injuries; Time Factors

Liver--spleen scintigraphy in patients who have incurred blunt abdominal trauma is accepted as a useful diagnostic tool. Abdominal and pelvic imaging to detect extrahepatic or extrasplenic sites of hemorrhage should be a routine part of liver--spleen imaging in the evaluation of blunt abdominal injury. A patient with mesenteric bleeding and a normal liver and spleen detected by liver--spleen scintigraphy is reported.

Topics: Abdomen; Abdominal Injuries; Aged; Hemorrhage; Humans; Liver; Male; Mesentery; Pelvis; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid; Wounds, Nonpenetrating

Topics: Abdominal Injuries; Adolescent; Child; Child, Preschool; Evaluation Studies as Topic; Female; Humans; Liver; Male; Radionuclide Imaging; Spleen; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

A review of splenic injuries at Cincinnati Children's Hospital Medical Center from July 1978 to June 1980 revealed this form of injury in 29 patients. Treatment without surgery was successful in 21 patients. Seven patients required operation. One patient died shortly after admission of severe associated injuries. All patients admitted with blunt abdominal trauma were initially treated conservatively. If the clinical state improved, after transfusions if necessary, or remained stable and there were no objective signs of further blood loss, conservative therapy was continued. Liver-spleen scans were obtained on an urgent basis to confirm the diagnosis of splenic injury in patients who did not undergo surgery. No complications of treatment without surgery were recognized. The satisfactory outcome in these patients suggests that there is a place for treatment without surgery in some children with splenic injury.

Topics: Abdominal Injuries; Accidents, Traffic; Adolescent; Child; Child, Preschool; Female; Humans; Male; Radionuclide Imaging; Spleen; Splenectomy; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Wounds, Penetrating

Topics: Abdominal Injuries; Biliary Tract; Child; Humans; Imino Acids; Liver; Organotechnetium Compounds; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Diethyl-iminodiacetic Acid; Technetium Tc 99m Sulfur Colloid

Ten children underwent splenic imaging with heat-denatured red blood cells labeled with technetium-99m (Tc-99m DRBC). The presenting problems included the heterotaxia syndrome, recurrent idiopathic thrombocytopenic purpura following splenectomy, mass in the left posterior hemithorax, and blunt abdominal trauma. In nine patients, the presence or absence of splenic tissue was established. A splenic hematoma was identified in the tenth patient. All patients were initially scanned with Tc-99m sulfur colloid (Tc-99m SC), and were selected for Tc-99m DRBC scintigraphy only after the results of the SC scans failed to establish the clinical problem beyond doubt. The availability of kits containing stannous ions, essential for efficient and stable labeling of red blood cells with Tc-99m and requiring only a small volume of blood, make splenic scintigraphy in children a relatively simple and definitive diagnostic procedure, when identification of splenic tissue is of clinical importance.

Topics: Abdominal Injuries; Adolescent; Child, Preschool; Erythrocytes; Female; Humans; Infant; Infant, Newborn; Isotope Labeling; Male; Purpura, Thrombocytopenic; Radionuclide Imaging; Reagent Kits, Diagnostic; Spleen; Sulfur; Syndrome; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Abdominal Injuries; Adult; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Wounds, Nonpenetrating

Increased bone marrow uptake of 99mTechnetium sulfur colloid is often seen in chronic liver diseases and severe anaemia. Four children with increased bone marrow uptake following severe, blunt abdominal trauma are described and the possible causes discussed.

Topics: Abdominal Injuries; Bone Marrow; Child; Child, Preschool; Female; Humans; Liver; Male; Radionuclide Imaging; Spleen; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Absence of the right hepatic lobe following blunt abdominal trauma without surgical resection is reported. The usual site of the right hepatic lobe is demonstrated to be occupied by bowel by hepatobiliary imaging.

Topics: Abdominal Injuries; Atrophy; Cholecystectomy; Cholecystitis; Humans; Imino Acids; Intestines; Liver; Liver Cirrhosis; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Time Factors; Wounds, Nonpenetrating