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游走脾合并脾囊肿:保留脾功能的腹腔镜治疗

Splenic cyst in a wandering spleen: laparoscopic treatment with preservation of splenic function.

作者信息

Falchetti Diego, Torri Fabio, Dughi Sergio, Porto Celeste, Manciana Alessandro, Boroni Giovanni, Ekema George

机构信息

Department of Pediatric Surgery, Spedali Civili, 25100 Brescia, Italy.

出版信息

J Pediatr Surg. 2007 Aug;42(8):1457-9. doi: 10.1016/j.jpedsurg.2007.03.063.

Abstract

BACKGROUND

Wandering spleen and splenic cyst are rare benign congenital conditions that can both cause severe complications related to torsion or trauma.

CASE REPORT

A 14-year-old girl presented a mobile 10-cm-long abdominal mass in the left lower quadrant associated with mild abdominal pain. The diagnosis of an 8-cm-long nonparasitic cyst in a wandering spleen was confirmed by computerized tomography and negative serum indirect hemagglutination titer for hydatid disease. Laparoscopic unroofing of the cyst and splenopexy in a vycril mesh was performed.

RESULTS

No problems were encountered during laparoscopic surgery. Postoperative course was uneventful, and at a 1-year follow-up, the spleen is viable and maintains a normal position in the phrenorenal angle.

CONCLUSIONS

In the child, treatment of wandering spleen associated with a cyst should aim at the prevention of vascular accidents and at conservation of the spleen. We achieved these goals with unroofing and splenopexy through laparoscopic surgery.

摘要

背景

游走脾和脾囊肿是罕见的先天性良性疾病,两者均可导致与扭转或创伤相关的严重并发症。

病例报告

一名14岁女孩左下象限出现一个可移动的10厘米长腹部肿块,并伴有轻度腹痛。计算机断层扫描证实为游走脾内一个8厘米长的非寄生虫性囊肿,血清包虫病间接血凝试验结果为阴性。采用腹腔镜囊肿去顶术并使用维克里网片进行脾固定术。

结果

腹腔镜手术过程中未遇到问题。术后病程平稳,在1年的随访中,脾脏存活且保持在脾肾角的正常位置。

结论

对于儿童游走脾合并囊肿的治疗,应旨在预防血管意外并保留脾脏。我们通过腹腔镜手术进行囊肿去顶术和脾固定术实现了这些目标。

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