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Robot Assisted difficult splenectomy due to splenomegaly with multiple abscesses & perisplenitis in a post-stem cell transplant patient

Gabriela M Aguiluz, MD, Roberto Bustos, MD, Valentina Valle, MD, Sam Papasotiriou, Pier C Giulianotti, MD, FACS. University of Illinois Hospital & Health Sciences System

This is a case of a patient on status post stem cell transplant and extensive infectious history, referred to surgery due to multiple splenic abscesses, splenic sequestration and pancytopenia that successfully underwent robot-assisted splenectomy.

A 53-year-old male, with history of myelofibrosis, post stem cell transplant, pancytopenic, presenting epistaxis and hematuria, and a recent admission due to cellulitis of inferior member, is referred to surgery for splenectomy due to multiple abscesses and splenic sequestration. The patient underwent a robot-assisted splenectomy. The procedure was carried out with no complications. The operative times was 222min, with an estimated blood loss of 150cc.

The postoperative course was uneventful and the patient was discharged on postoperative day 6. Pathology reported spleen measuring 19.2×14.3×8.5 with multiple targetoid regions of coagulative necrosis with surrounding palisading histocytes and Langhans cells. 1 month post surgery, patient presented with improved platelet count and WBC, resolution of epistaxis and reduced hematuria.

Resection of large spleen in a minimally invasive fashion was successful in an immunocompromised patient with multiple splenic abscesses with a careful and precise dissection.

               


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94558

Program Number: V238

Presentation Session: Video Loop Day 2

Presentation Type: VideoLoop

Post Views: 11

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