Faculty of Medicine

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    Clinical Management and Surgical Outcomes of Wandering Spleen with Splenic Torsion in Pediatric Patients: A Case Report
    (Albanian Society for Trauma and Emergency Surgery, 2025-01)
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    Kuci, Saimir
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    Lazar Todorovic
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    Kamilovski, Marijan
    Introduction: Wandering Spleen is a rare condition in which the splenic ligaments are abnormally loose or absent. This makes the Spleen more mobile and increases the risk of torsion. This case report outlines the clinical presentation and management of a 10-year-old female patient who presented at our clinic with acute abdominal pain, vomiting episodes, and a severe fever. Imaging tests, such as abdominal ultrasonography and computed tomography, confirmed the diagnosis of splenic torsion by showing a hemorrhagic infarction and a large spleen. We performed a splenectomy to remove the damaged organ, a partial omental resection to remove the dead tissue and removed the mesenteric lymph nodes for further pathological examination. After the surgical procedure, the intensive care unit carefully observed the patient and treated her with intravenous electrolyte replacement, broad-spectrum antibiotics, pain management, and measures to prevent thrombosis. This case highlights the critical need for early diagnosis and timely surgical intervention in cases of wandering Spleen to prevent serious complications, including splenic infarction. By presenting this case, we seek to elevate awareness of wandering Spleen among healthcare professionals, mainly within pediatric groups. We emphasize the importance of timely diagnosis and appropriate management to optimize patient outcomes. Conclusion: Early detection and prompt intervention are crucial in preventing severe complications in pediatric patients. This case emphasizes the necessity of rapid diagnosis and increased awareness in clinical practice. Due to the Spleen's impaired viability, a splenectomy was required. Following surgery, we provided comprehensive monitoring and pharmaceutical assistance to control pain, prevent infection, and maintain nutritional stability.
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    Pediatric Echinococcosis: diagnosis, urgent surgical intervention, and treatment – case report
    (Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2024-11)
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    Sulejmani, Haris
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    Racaj, Anila
    Echinococcus tapeworms cause human echinococcosis, which causes hydatid cysts, most commonly in the liver and lungs but also in other organs. Delays in symptom onset can lead to diagnostic issues, especially in children. Pediatric cases are rare and often lead to unintentional diagnoses. Living in a rural area increases risk. Imaging and serological testing are essential for diagnosis. This case is rare since it involves pediatric echinococcosis. Children rarely get echinococcosis, and symptoms are often vague; thus, diagnosis is mainly by accident. Case report: A 10-year-old female child developed symptoms and signs such as tachycardia, fever, and facial urticaria. On the first clinical examination, classic signs of an acute abdomen were present, indicating a possible abdominal emergency. Laboratory results showed significantly high levels of inflammatory markers, including CRP and WBC, indicating an active inflammatory process, most likely caused by infection or tissue injury. Imaging examinations, particularly a contrast CT scan of the abdomen, revealed two burst liver cysts in the peritoneal cavity, confirming the diagnosis of echinococcal cysts in the liver. We undertook an urgent surgical intervention to address the burst cysts and avert potential complications like peritonitis or sepsis. Post-operative treatment included constant monitoring of the patient's condition, antibiotic and antihelminthic medication to control infection, pain management, and supportive measures to help with recovery. Echinococcosis in children manifests as nonspecific symptoms, which often leads to a rare suspicion and coincidental diagnosis. Echinococcosis is often considered a possible cause of stomach discomfort. The standard treatment for echinococcosis usually involves a combination of antiparasitic medication and surgical removal of the cyst.