Rahili Amine, Karimdjee Babou Soilihi, Hastier Patrick, Myx Aline, Juwid Abdallah, Benchimol Daniel, Bourgeon André
Service de Chirurgie Générale et Cancérologie Digestive, Hôpital Archet II, Université Nice Sophia Antipolis, route de Saint-Antoine-de-Ginestière.
Gastroenterol Clin Biol. 2005 May;29(5):604-6. doi: 10.1016/s0399-8320(05)82137-2.
Spontaneous rupture of the spleen is a rare complication of chronic calcifying pancreatitis. Anemia and hemorrhagic shock may not occur, making diagnosis more difficult. Favourable response to conservative treatment does not prevent the need for splenectomy, as calcifiying chronic pancreatitis may progress locally. We report three cases of spontaneous rupture of the spleen. In two cases, splenic rupture revealed calcifying chronic pancreatitis and both patients underwent urgent splenectomy. In the third case, the patient was known to have calcifying chronic pancreatitis, and splenectomy was performed because of unsuccessful conservative treatment. We discuss the role of distal pancreatectomy during splenectomy to reduce the rate of postoperative complications and additional surgery. We also discuss the role of arterial embolisation and laparoscopy in the management of this rare condition.
脾自发性破裂是慢性钙化性胰腺炎的一种罕见并发症。可能不会出现贫血和失血性休克,这使得诊断更加困难。对保守治疗的良好反应并不能避免行脾切除术的必要性,因为钙化性慢性胰腺炎可能会局部进展。我们报告三例脾自发性破裂病例。其中两例脾破裂显示为钙化性慢性胰腺炎,两名患者均接受了急诊脾切除术。第三例患者已知患有钙化性慢性胰腺炎,因保守治疗未成功而接受了脾切除术。我们讨论了在脾切除术中进行远端胰腺切除术以降低术后并发症发生率和再次手术的作用。我们还讨论了动脉栓塞和腹腔镜检查在这种罕见疾病治疗中的作用。