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Bakhsh A, Ghandourah H, Alakrawi K, Alsahafi E, Saklou R. Splenic Peliosis as a Rare Cause of Spontaneous Splenic Rupture: A Case Report. Cureus 2024; 16:e55839. [PMID: 38463409 PMCID: PMC10924470 DOI: 10.7759/cureus.55839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 03/12/2024] Open
Abstract
Atraumatic splenic rupture is a serious intraabdominal emergency that requires emergent intervention. This can be due to a number of causes. In this case report, we introduce a rare cause of atraumatic splenic rupture, which is an otherwise benign asymptomatic disease that only manifests clinically upon rupture, namely splenic peliosis. There is limited existing knowledge concerning the disease's etiology and diagnosis; however, this study presents the possible etiological explanations, associated risk factors, and possible radiologic diagnostic modalities.
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Affiliation(s)
- Amal Bakhsh
- Department of Diagnostic Radiology, King Fahad General Hospital, Jeddah, SAU
| | - Hussain Ghandourah
- Department of Diagnostic Radiology, King Fahad General Hospital, Jeddah, SAU
| | - Khatoon Alakrawi
- Department of General Surgery, King Fahad General Hospital, Jeddah, SAU
| | - Eman Alsahafi
- Department of Diagnostic Radiology, King Fahad General Hospital, Jeddah, SAU
| | - Rana Saklou
- Department of Diagnostic Radiology, King Fahad General Hospital, Jeddah, SAU
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2
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Lotfi CL, Adams CE, Saint-Hilaire R. Close Call After a Fall: Understanding Traumatic and Atraumatic Splenic Rupture and Its Life-Threatening Consequences. Cureus 2023; 15:e45544. [PMID: 37868388 PMCID: PMC10586229 DOI: 10.7759/cureus.45544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Splenic rupture, a critical surgical emergency involving the tearing of the spleen's capsule and the ensuing internal bleeding, primarily results from abdominal trauma or underlying medical conditions affecting the spleen. A 71-year-old male with hypertension and hyperlipidemia suffered a mechanical fall, leading to his presentation in the emergency department. Despite a stable initial condition and discharge, he returned the following day with dizziness and severe anemia. Subsequent diagnostics revealed a ruptured spleen, necessitating immediate surgical intervention. This case emphasizes traumatic and atraumatic causes of splenic rupture, with older adults, anticoagulant users, and viral illnesses accentuating vulnerability. Physical exam findings might be absent, highlighting the importance of considering splenic rupture in cases of unexplained hemodynamic instability. In this instance, a combination of trauma, a possible history of anticoagulation use, and a recent viral illness contributed to the patient's splenic rupture. The case underscores the need to retain a high index of suspicion for splenic rupture even without obvious physical findings, advocating for diligent evaluation of abnormal vital signs.
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Affiliation(s)
- Cheri L Lotfi
- Anesthesiology, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Charles E Adams
- Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA
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Reyes-Jaimes L, Camacho-Aguilera JF. [Spontaneous splenic rupture. Case report and literature review]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:523-531. [PMID: 37540732 PMCID: PMC10484555 DOI: 10.5281/zenodo.8200591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/04/2023] [Indexed: 08/06/2023]
Abstract
Background Spontaneous splenic rupture is often life threatening due to delay in diagnosis and treatment. Abdominal pain, Kehr's sign, nausea, bloating, altered consciousness, and intestinal obstruction may be present. In larger splenic lesions, signs of peritonitis and hypovolemic shock are present. Contrast-enhanced computed tomography is the election study. Diagnosis is confirmed by negative viral serology and normal spleen on gross and histopathologic inspection. The most frequent treatment in splenectomy. Clinic case A 30-year-old male with no medical history presented with generalized abdominal pain accompanied by Kehr's sign. He is diagnosed with ruptured spleen by contrast-enhanced computed tomography and successfully treated with splenectomy. He was discharged 6 days after surgery. Conclusions Spontaneous rupture of the spleen is uncommon, but with high morbidity and mortality. It must be a differential diagnosis in the face of abdominal and/or chest pain, and the corresponding imaging studies should be carried out if the patient's conditions allow it, or their search during an exploratory laparotomy.
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Affiliation(s)
- Libertad Reyes-Jaimes
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 3, Servicio de Cirugía General. San Juan del Río, Querétaro, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - José Francisco Camacho-Aguilera
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 3, Servicio de Cirugía General. San Juan del Río, Querétaro, MéxicoInstituto Mexicano del Seguro SocialMéxico
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4
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Association of Atraumatic Splenic Rupture and Acute Pancreatitis: Case Report with Literature Review. Case Rep Surg 2022; 2022:8743118. [PMID: 35198257 PMCID: PMC8860542 DOI: 10.1155/2022/8743118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/29/2022] [Indexed: 11/26/2022] Open
Abstract
Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This article presents a case of a 35-year-old patient presenting with acute pancreatitis who subsequently developed a splenic vein thrombosis and splenic rupture requiring a laparotomy and splenectomy. This rare but life-threatening complication requires prompt recognition and management in patients with pancreatitis who develop sudden hemodynamic instability.
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Descloux E, Mediannikov O, Gourinat AC, Colot J, Chauvet M, Mermoud I, Desoutter D, Cazorla C, Klement-Frutos E, Antonini L, Levasseur A, Bossi V, Davoust B, Merlet A, Goujart MA, Oedin M, Brescia F, Laumond S, Fournier PE, Raoult D. Flying Fox Hemolytic Fever, Description of a New Zoonosis Caused by Candidatus Mycoplasma haemohominis. Clin Infect Dis 2020; 73:e1445-e1453. [PMID: 33119064 DOI: 10.1093/cid/ciaa1648] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Hemotropic mycoplasmas, previously classified in the genus Eperythrozoon, have been reported as causing human infections in Brazil, China, Japan, and Spain. METHODS In 2017, we detected DNA from Candidatus Mycoplasma haemohominis in the blood of a Melanesian patient from New Caledonia presenting with febrile splenomegaly, weight loss, life-threatening autoimmune hemolytic anemia, and hemophagocytosis. The full genome of the bacterium was sequenced from a blood isolate. Subsequently, we retrospectively (2011-2017) and prospectively (2018-2019) tested patients who had been hospitalized with a similar clinico-biological picture. In addition, as these patients had been in contact with frugivorous bats (authorized under conditions for hunting and eating in New Caledonia), we investigated the role of these animals and their biting flies by testing them for hemotropic mycoplasmas. RESULTS There were 15 patients found to be infected by this hemotropic mycoplasma. Among them, 4 (27%) died following splenectomy performed either for spontaneous spleen rupture or to cure refractory autoimmune hemolytic anemia. The bacterium was cultivated from the patient's blood. The full genome of the Neocaledonian Candidatus M. haemohominis strain differed from that of a recently identified Japanese strain. Of 40 tested Pteropus bats, 40% were positive; 100% of collected bat flies Cyclopodia horsfieldi (Nycteribiidae, Diptera) were positive. Human, bat, and dipteran strains were highly similar. CONCLUSIONS The bacterium being widely distributed in bats, Candidatus M. haemohominis, should be regarded as a potential cause of severe infections in humans.
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Affiliation(s)
- Elodie Descloux
- Service de Médecine Interne et Infectiologie, Centre Hospitalier Territorial Gaston Bourret, Noumea, Nouvelle Calédonie
| | - Oleg Mediannikov
- Aix Marseille University, Institut pour la recherche et le développement, Assistance Publique-Hôpitaux de Marseille, Microbes, Evolution, Phylogénie et Infection, Institut hospitalo-Universitaire-Méditerranée Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Ann-Claire Gourinat
- Laboratoire de Microbiologie, Centre Hospitalier Territorial Gaston Bourret, Noumea, Nouvelle Calédonie
| | - Julien Colot
- Laboratoire de Microbiologie, Centre Hospitalier Territorial Gaston Bourret, Noumea, Nouvelle Calédonie.,Laboratoire de Bactériologie, Institut Pasteur, Noumea, Nouvelle Calédonie
| | - Martine Chauvet
- Laboratoire de Microbiologie, Centre Hospitalier Territorial Gaston Bourret, Noumea, Nouvelle Calédonie
| | - Isabelle Mermoud
- Laboratoire de Nouvelle Calédonie, Direction des Affaires Vétérinaires, Alimentaires et Rurales, Noumea, Nouvelle Calédonie
| | - Denise Desoutter
- Laboratoire de Nouvelle Calédonie, Direction des Affaires Vétérinaires, Alimentaires et Rurales, Noumea, Nouvelle Calédonie
| | - Cécile Cazorla
- Service de Médecine Interne et Infectiologie, Centre Hospitalier Territorial Gaston Bourret, Noumea, Nouvelle Calédonie
| | - Elise Klement-Frutos
- Service de Médecine Interne et Infectiologie, Centre Hospitalier Territorial Gaston Bourret, Noumea, Nouvelle Calédonie
| | - Luca Antonini
- Service de Médecine Interne, Centre Hospitalo-universitaire de Caen, Caen, France
| | - Anthony Levasseur
- Aix Marseille University, Institut pour la recherche et le développement, Assistance Publique-Hôpitaux de Marseille, Microbes, Evolution, Phylogénie et Infection, Institut hospitalo-Universitaire-Méditerranée Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Vincent Bossi
- Aix Marseille University, Institut pour la recherche et le développement, Assistance Publique-Hôpitaux de Marseille, Microbes, Evolution, Phylogénie et Infection, Institut hospitalo-Universitaire-Méditerranée Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Bernard Davoust
- Aix Marseille University, Institut pour la recherche et le développement, Assistance Publique-Hôpitaux de Marseille, Microbes, Evolution, Phylogénie et Infection, Institut hospitalo-Universitaire-Méditerranée Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Audrey Merlet
- Service de Médecine Interne et Infectiologie, Centre Hospitalier Territorial Gaston Bourret, Noumea, Nouvelle Calédonie
| | - Marie-Amélie Goujart
- Laboratoire d'Hématologie, Centre Hospitalier Territorial Gaston Bourret, Noumea, Nouvelle Calédonie
| | - Malik Oedin
- Institut Agronomique Néo-Calédonien, Equipe Agriculture Biodiversité et Valorisation (ARBOREAL), Païta, Nouvelle-Calédonie
| | - Fabrice Brescia
- Institut Agronomique Néo-Calédonien, Equipe Agriculture Biodiversité et Valorisation (ARBOREAL), Païta, Nouvelle-Calédonie
| | - Sylvie Laumond
- Service de Santé Publique, Direction des Affaires Sanitaires et Sociales de Nouvelle Calédonie, Noumea, Nouvelle Calédonie
| | - Pierre-Edouard Fournier
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, Assistance Publique-Hôpitaux de Marseille, service de santé des armées, Vecteurs - Infections Tropicales et Méditeranéennes, Institut hospitalo-Universitaire-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix Marseille University, Institut pour la recherche et le développement, Assistance Publique-Hôpitaux de Marseille, Microbes, Evolution, Phylogénie et Infection, Institut hospitalo-Universitaire-Méditerranée Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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Ünal E, Arslan S, Onur MR, Akpinar E. Parasitic diseases as a cause of acute abdominal pain: imaging findings. Insights Imaging 2020; 11:86. [PMID: 32691171 PMCID: PMC7371776 DOI: 10.1186/s13244-020-00892-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/29/2020] [Indexed: 12/13/2022] Open
Abstract
Acute abdominal pain can be seen in cases with parasitic diseases delivered to emergency departments. The diagnosis of the parasitic disease can be delayed because of the similar clinical signs encountered in other frequently seen causes of acute abdomen. Nevertheless, the features detected in imaging scans can be helpful in the diagnosis. The present study aims to raise awareness about abdominal parasitosis in emergency conditions and also to underline the association between imaging findings and the life cycle of parasites with illustrative cases.
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Affiliation(s)
- Emre Ünal
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey.
| | - Sevtap Arslan
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| | - Mehmet Ruhi Onur
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| | - Erhan Akpinar
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
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Li H, Guan D, Xu J, Jin E, Sun S. Atraumatic splenic rupture was attributed to intra-cystic haemorrhage and hypersplenism in a patient with cirrhosis and portal hypertension: A case report. SAGE Open Med Case Rep 2020; 8:2050313X20901900. [PMID: 32047630 PMCID: PMC6984417 DOI: 10.1177/2050313x20901900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 12/31/2019] [Indexed: 11/18/2022] Open
Abstract
Liver cirrhosis with splenomegaly and portal hypertension has been described in the medical literature as increasing the risk of splenic rupture. We report a case of atraumatic splenic rupture in a male with liver cirrhosis associated with splenomegaly, which was further complicated by hypersplenism and intra-cystic haemorrhage in the spleen. The 56-year-old man was hospitalized because of sudden onset of intermittent pain in the left quadrant abdomen with no history of trauma. Upon admission, the patient presented no fever, palpable abdominal tenderness, splenomegaly, and hypersplenism. Enhanced computed tomography revealed a splenic subcapsular haematoma connected to a cystic mass located at the splenic hilum and free fluid in the abdomen, which is indicative of splenic rupture. The patient underwent immediate laparotomy and splenectomy followed by proper management. Post-surgery diagnostic microscopy indicated liver steatosis, perivenular fibrosis, and regenerative nodules, which are suggestive of cirrhosis. The patient was discharged from the hospital with an uneventful recovery.
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Affiliation(s)
- Hao Li
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Yanbian University, Yanji, P.R. China
| | - Dongyao Guan
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Yanbian University, Yanji, P.R. China
| | - Junqiang Xu
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Yanbian University, Yanji, P.R. China
| | - Enhao Jin
- Department of Imaging, Affiliated Hospital of Yanbian University, Yanji, P.R. China
| | - Shu Sun
- Department of Pathology, Affiliated Hospital of Yanbian University, Yanji, P.R. China
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Radwan I, Magdy Khattab M, Mahmoud AR, Nghia TLB, Y MN, Trung DT, Hirayama K, Huy NT. Systematic review of spontaneous splenic rupture in dengue-infected patients. Rev Med Virol 2019; 29:e2029. [PMID: 30609179 DOI: 10.1002/rmv.2029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 11/06/2022]
Abstract
Dengue infection varies from a mild febrile form to more severe disease with plasma leakage, shock, and multiorgan failure. Several serious complications such as cardiomyopathy, encephalopathy, encephalitis, hepatic damage, and neural manifestations cause organ damage in dengue infection. Splenic rupture, a less well known but life-threatening complication, can occur in dengue. The mechanism of splenic rupture in dengue is still unclear. Optimal therapeutic management is required to save the lives of patients with this complication. The objective of this study was to conduct a systematic review of studies documenting the development of spontaneous nontraumatic splenic rupture in patients with dengue infection. In March 2018, a search was conducted systematically in nine electronic databases, in addition to hand- searching. A total of 127 references were exported to Endnote; 47 references remained after removing duplicates. Finally, 16 reports met the inclusion criteria and represented 17 cases. All articles were evaluated and data extracted according to predefined criteria: number of cases, age, sex, severity of dengue disease, days of illness before admission, methods of definitive diagnosis, timing of the event, and management and outcome. A total of 17 individual patients including 13 males and four females were found. Most of the patients were young adults (ranging from 20 to 52 years) and diagnosed with computed tomography scan and managed with splenectomy. Four cases were fatal. Pathological splenic rupture in dengue is a rare, life-threatening condition where timely management can achieve a favorable outcome.
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Affiliation(s)
- Ibrahim Radwan
- Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org
| | - Mohamed Magdy Khattab
- Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org.,Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Abdalla Reda Mahmoud
- Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org.,Faculty of Medicine, Minia University, Minia, Egypt
| | - Thai Le Ba Nghia
- Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org.,Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Mai Nhu Y
- Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org.,Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Dinh The Trung
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Sangüesa Nebot C, Carazo Palacios E, Lorens Salvador R, Picó Aliaga S. Non-traumatic spleen disorders in children. Assessment by imaging. RADIOLOGIA 2019. [DOI: 10.1016/j.rxeng.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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10
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Sangüesa Nebot C, Palacios EC, Lorens Salvador R, Aliaga SP. El bazo pediátrico no traumático. Valoración por imagen. RADIOLOGIA 2019; 61:16-25. [DOI: 10.1016/j.rx.2018.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/27/2018] [Accepted: 07/29/2018] [Indexed: 02/07/2023]
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Sahin AN, Schwenter F, Sebajang H. Clinical presentation and management of atraumatic splenic rupture. Clin Case Rep 2018; 6:2279-2280. [PMID: 30455937 PMCID: PMC6230640 DOI: 10.1002/ccr3.1792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/14/2018] [Accepted: 08/14/2018] [Indexed: 11/11/2022] Open
Abstract
Atraumatic splenic rupture is a rare, but well-documented and life-threatening clinical entity that is often misdiagnosed. Clinicians should include this entity in their differential diagnosis using clinical judgement even in the absence of a history of trauma.
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Affiliation(s)
- Alain N. Sahin
- Department of SurgeryCentre hospitalier de l'Université de MontréalMontréalQuébecCanada
- Department of SurgeryUniversité de MontréalMontréalQuébecCanada
| | - Frank Schwenter
- Department of SurgeryCentre hospitalier de l'Université de MontréalMontréalQuébecCanada
- Department of SurgeryUniversité de MontréalMontréalQuébecCanada
| | - Herawaty Sebajang
- Department of SurgeryCentre hospitalier de l'Université de MontréalMontréalQuébecCanada
- Department of SurgeryUniversité de MontréalMontréalQuébecCanada
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