McClenathan J H
Department of Surgery, Kaiser Permanente Medical Center, Santa Clara, Calif. 95051.
Can J Surg. 1991 Apr;34(2):175-8.
A rare complication of splenectomy is gastric perforation and fistula. Patients with this complication often complain of pain in the left upper quadrant and left shoulder, and of fever, tachycardia and upper abdominal tenderness. Chest radiographs often show a pleural effusion in the left hemithorax. Patients usually exhibit increased drainage from the tube in the left upper quadrant or a collection of fluid in the left subphrenic space. The diagnosis can be confirmed by radiography after ingestion of meglumine diatrizoate (Gastrografin). Treatment by nasogastric suction and adequate drainage of the left subphrenic space allows some of these fistulas to close. In some cases operative closure is necessary. With appropriate treatment, 75% of these patients can be expected to recover.
脾切除术后一种罕见的并发症是胃穿孔和胃瘘。患有这种并发症的患者常诉说左上腹和左肩疼痛，伴有发热、心动过速和上腹部压痛。胸部X线片常显示左半胸有胸腔积液。患者通常表现为左上腹引流管引流量增加或左膈下间隙有液体聚集。摄入泛影葡胺（ Gastrografin）后进行X线检查可确诊。通过鼻胃管吸引和充分引流左膈下间隙，部分胃瘘可自行闭合。在某些情况下，需要手术闭合。经过适当治疗，预计这些患者中有75%能够康复。
