Warren M S, Gibbons R B
Department of Medicine, Saint Joseph Hospital, Denver.
Chest. 1991 Aug;100(2):574-5. doi: 10.1378/chest.100.2.574.
The association of left-sided pleural effusion and subcapsular splenic hematoma was reported in 1980. We describe a patient in whom a left-sided pleural effusion resulted from splenic vein thrombosis, a relationship not previously reported. Splenectomy was performed, demonstrating the spleen to be enlarged and hemorrhagic. The pleural effusion did not recur after splenectomy. The three effusions due to splenic hematomas reported previously cleared only after splenectomy, suggesting splenectomy may be necessary to prevent reaccumulation. We propose possible pathophysiologic mechanisms and recommend that splenic vein thrombosis be considered in the differential diagnosis of unexplained left-sided pleural effusions.
1980年曾有左侧胸腔积液与脾包膜下血肿相关联的报道。我们描述了一名患者，其左侧胸腔积液由脾静脉血栓形成所致，这种关系此前未见报道。患者接受了脾切除术，术中发现脾脏肿大且有出血。脾切除术后胸腔积液未再复发。之前报道的三例因脾血肿导致的胸腔积液仅在脾切除术后才消退，提示可能有必要进行脾切除术以防止积液再次积聚。我们提出了可能的病理生理机制，并建议在不明原因的左侧胸腔积液的鉴别诊断中考虑脾静脉血栓形成。
