Kleiner Oleg, Newman Nitza, Cohen Zahavi
Department of Pediatric Surgery, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
J Laparoendosc Adv Surg Tech A. 2006 Jun;16(3):328-30. doi: 10.1089/lap.2006.16.328.
Wandering spleen is a rare clinical condition associated with a high incidence of splenic torsion and infarction. The preferred treatment is splenopexy to reposition the spleen in the left upper quadrant of the abdomen. We report the case of a 12-year-old girl who presented with intermittent abdominal pain. An abdominal sonography was diagnostic of wandering spleen. The patient was successfully treated by laparoscopic splenopexy. The spleen was repositioned in the left upper quadrant and fixed to the posterior abdominal wall by a mesh patch attached by staples. To reinforce the splenopexy we created an additional support by plicating the phrenocolic ligament and suturing it to the lateral abdominal wall, making a pouch for the inferior pole of the spleen. The postoperative course was rapid and uneventful. A normal spleen position was verified by radionuclide scans at 3 days and 6 months postoperatively. Laparoscopic splenopexy is an excellent option for organ-preserving treatment in wandering spleen.
游走脾是一种罕见的临床病症，与脾扭转和梗死的高发生率相关。首选治疗方法是脾固定术，即将脾脏重新定位到腹部左上象限。我们报告一例12岁女孩，她出现间歇性腹痛。腹部超声检查诊断为游走脾。该患者通过腹腔镜脾固定术成功治愈。脾脏被重新定位到左上象限，并通过用吻合钉固定的网片固定于后腹壁。为加强脾固定术，我们通过折叠膈结肠韧带并将其缝合至侧腹壁为脾脏下极制作一个囊袋，从而创建了一个额外的支撑。术后病程进展迅速且平稳。术后3天和6个月通过放射性核素扫描证实脾脏位置正常。腹腔镜脾固定术是游走脾保留器官治疗的极佳选择。
