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血液透析患者发生自发性脾破裂:病例报告及文献复习。

Spontaneous splenic rupture in a patient who received haemodialysis: case report and a review of the literature.

机构信息

Department of General Surgery, Taipei Medical University-Municipal Wan Fang Hospital, Taipei, Taiwan.

出版信息

Emerg Med J. 2009 Dec;26(12):915-6. doi: 10.1136/emj.2008.065896.

Abstract

Spontaneous splenic rupture is an extremely rare complication in patients who received haemodialysis. We describe a 51-year-old woman who underwent regular haemodialysis and was admitted because of sudden onset of abdominal pain, hypovolemic shock and dizziness. Haemoperitoneum caused by spontaneous rupture of spleen was found on abdominal CT scan. Emergency splenectomy was performed, and the patient was discharged 9 days after the admission. This report demonstrates that spontaneous splenic rupture requires a high index of suspicion for diagnosis in a patient who received haemodialysis with abdominal pain and should be considered in the differential diagnosis when a patient who received haemodialysis without any trauma history has abdominal pain with unexplained hypovolemic shock.

摘要

自发性脾破裂是接受血液透析患者极罕见的并发症。我们描述了一位 51 岁女性,她定期接受血液透析,并因突发腹痛、低血容量性休克和头晕而入院。腹部 CT 扫描发现脾自发性破裂导致的血腹。紧急行脾切除术,患者在入院后 9 天出院。本报告表明,对于接受血液透析且有腹痛的患者,自发性脾破裂的诊断需要高度怀疑,并且当无创伤史的接受血液透析的患者出现不明原因的低血容量性休克伴腹痛时,应考虑作为鉴别诊断。

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