Pogoda Pia, Izbicki Jakob R, Langwieler Thomas E, Staedtler Carsten, Busch Christoph
Department of Surgery, Hamburg University School of Medicine, D-20246 Hamburg, Germany.
Dig Surg. 2002;19(1):59-63. doi: 10.1159/000052008.
Bronchogenic cysts are rare congenital cystic lesions of foregut origin. They are the result of abnormal budding of the primitive tracheobronchial tube. Nonparasitic, true splenic cysts are another rare entity that might occur as incidental findings but may lead to deleterious courses in case of ruptures.
We report here the first case of the uncommon association of a paraesophageal bronchogenic cyst and multiple primary splenic cysts in a 23-year-old woman suffering from dysphagia and chest pain. Successful complete resection of the paraesophageal cyst was performed using an abdominal, transhiatal approach and splenic cysts were subjected to organ-preserving TA stapler resection.
Thus far there is no proof or genetic indication for a direct association of bronchogenic cysts and multiple splenic cysts, however, the uncommon coincidence of both lesions in our patient might suggest a common origin. Difficulties in preoperative diagnosis, histopathological characteristics and surgical treatment modalities are presented.
支气管源性囊肿是罕见的源于前肠的先天性囊性病变。它们是原始气管支气管管异常出芽的结果。非寄生虫性真性脾囊肿是另一种罕见的情况,可能作为偶然发现出现,但在破裂时可能导致有害后果。
我们在此报告首例23岁患有吞咽困难和胸痛的女性患者,其出现罕见的食管旁支气管源性囊肿与多发性原发性脾囊肿并存的情况。采用经腹经裂孔入路成功完整切除食管旁囊肿,脾囊肿则采用保留器官的TA吻合器切除术。
迄今为止,尚无证据或遗传学指征表明支气管源性囊肿与多发性脾囊肿存在直接关联,然而,我们患者中这两种病变的罕见并存可能提示有共同起源。文中介绍了术前诊断的困难、组织病理学特征及手术治疗方式。