c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Laparoscopic ITP Splenectomy: 1

A D V E R T I S E M E N T

   
 

A 43-year-old man with a 2-year history of idiopathic thrombocytopenic purpura (ITP) presented for splenectomy for failure of medical therapy (see discussion). The patientís platelet count repeatedly dropped into the 20,000 range after initial response to courses of steroids. CT scan showed the spleen to be slightly enlarged, and there was no evidence of accessory spleens (see accessory spleen, and splenic anatomy.)     

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Laparoscopic ITP Splenectomy: 2

A D V E R T I S E M E N T

   
 

The patient was given a 6-day course of prednisone, 60 mg per day prior to surgery, and the platelet count was 110K on the day of surgery. The patientís chest was rotated to the right with pneumatic beanbag support.       

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Laparoscopic ITP Splenectomy: 3

A D V E R T I S E M E N T

   
 

The patient position, with left arm supported on a suspension arm board and the table broken at the waist, is shown. A pillow was placed between the legs, and chest and hips were secured with tape and strap respectively. Pneumatic compression devices were placed on the calves.      

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This page was last modified on 5/23/2005.