Falchetti Diego, Torri Fabio, Dughi Sergio, Porto Celeste, Manciana Alessandro, Boroni Giovanni, Ekema George
Department of Pediatric Surgery, Spedali Civili, 25100 Brescia, Italy.
J Pediatr Surg. 2007 Aug;42(8):1457-9. doi: 10.1016/j.jpedsurg.2007.03.063.
Wandering spleen and splenic cyst are rare benign congenital conditions that can both cause severe complications related to torsion or trauma.
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.
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.
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.
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。
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。
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。
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。