Culafić Dordde M, Kerkez Mirko D, Mijac Dragana D, Lekić Nebojsa S, Ranković Vitomir I, Lekić Dragana D, Dordević Zoran Lj
Clinic of Gastroenterology and Hepatology, Medical Faculty, Institute of Digestive Diseases, Clinical Center of Serbia, Dr Koste Todorovica No 2, 11 000 Belgrade, Serbia.
Scand J Gastroenterol. 2010;45(2):186-90. doi: 10.3109/00365520903428598.
The aim of our study was to demonstrate clinical manifestations and diagnostic methods of splenic echinococcosis and suggest surgical approach.
The study involved 20 patients of previously diagnosed spleen echinococcosis. A diagnosis was made for each patient, based on medical history, biochemical and serological tests, physical examination and abdominal ultrasonography. All the patients received a CT scan of the abdomen. These patients had undergone the following surgery procedures: total splenectomy 13 (60%), and spleen-preserving surgery 7 (35%) patients. Histological examination confirmed the spleen echinoccocosis in all the patients.
Nonspecific left upper abdominal pain was present in 10 (50%) cases, while 5 (25%) patients presented with the right upper abdominal pain with dyspepsia and five patients (25%) were asymptomatic. Postoperative complications developed in 2/13 (15.4 %) patients who underwent total splenectomy, while there were no complications after spleen-preserving surgery.
Spleen-preserving surgery should be undertaken if possible in patients with spleen echinococcosis, and total splenectomy is reserved for the patients with large cysts located centrally or near the hilus.
本研究旨在阐述脾包虫病的临床表现、诊断方法并提出手术方案。
本研究纳入20例先前诊断为脾包虫病的患者。根据病史、生化及血清学检查、体格检查和腹部超声对每位患者进行诊断。所有患者均接受腹部CT扫描。这些患者接受了以下手术:全脾切除术13例(60%),保脾手术7例(35%)。组织学检查证实所有患者均为脾包虫病。
10例(50%)患者出现左上腹非特异性疼痛,5例(25%)患者出现右上腹疼痛伴消化不良,5例(25%)患者无症状。接受全脾切除术的2/13例(15.4%)患者出现术后并发症,而保脾手术后无并发症发生。
脾包虫病患者若有可能应行保脾手术,全脾切除术仅适用于囊肿位于中央或靠近脾门的大型囊肿患者。