Seyama Yasuji, Tanaka Nobutaka, Suzuki Yoshio, Nagai Motoki, Furuya Takatoshi, Nomura Yukihiro, Ishii Jimpei, Nobori Masakazu
Department of Surgery, Asahi General Hospital, I-1326, Asahi City, Chiba 289-2511, Japan.
World J Gastroenterol. 2006 Apr 7;12(13):2133-5. doi: 10.3748/wjg.v12.i13.2133.
Spontaneous rupture is a rare complication of splenic hamartoma. A review of the literature revealed only four such cases. To the best of our knowledge, this is the first report of spontaneous rupture of splenic hamartoma associated with liver cirrhosis and portal hypertension. A 53-year-old woman, who was followed up for aortic dissection and hepatitis C virus (HCV)-related liver cirrhosis, was referred with sudden left chest and shoulder pain. An abdominal ultrasound showed intraabdominal bleeding, and computed tomography indicated rupture of a splenic tumor. Emergent splenectomy was carried out. The postoperative course was uneventful, and the patient was discharged on the 13th postoperative day. Pathology revealed the tumor to be a ruptured splenic hamartoma. The non-tumorous splenic parenchyma revealed congestive changes. We consider that the presence of liver cirrhosis and portal hypertension are risk factors for spontaneous rupture of the splenic hamartoma.
自发性破裂是脾错构瘤的一种罕见并发症。文献回顾仅发现4例此类病例。据我们所知,这是首例与肝硬化和门静脉高压相关的脾错构瘤自发性破裂的报告。一名53岁女性,因主动脉夹层和丙型肝炎病毒(HCV)相关肝硬化接受随访,因突发左胸和肩部疼痛前来就诊。腹部超声显示腹腔内出血,计算机断层扫描提示脾肿瘤破裂。遂行急诊脾切除术。术后过程顺利,患者于术后第13天出院。病理检查显示肿瘤为破裂的脾错构瘤。非肿瘤性脾实质显示充血性改变。我们认为肝硬化和门静脉高压的存在是脾错构瘤自发性破裂的危险因素。