Fukunaga Y, Usui N, Hirohashi K, Kimura E, Lee K C, Lee N, Kubota D, Kinoshita H
Second Department of Surgery, Osaka City University Medical School, Japan.
Osaka City Med J. 1990 Nov;36(2):161-73.
We have treated three cases of splenic artery aneurysms recently, so we reported them with a review of 181 cases in Japan. All three cases are women and have characteristic clinical courses and pathogenesis in each to which we performed a reasonable operation so that they could be saved. First one is a ruptured case. So we performed ligation of the splenic artery from inside the aneurysm under 9 min.'s clamp of the aorta. Second one was pointed out the splenic artery aneurysm during admission for cholecystectomy, so we performed splenectomy and aneurysmectomy, and after that we reconstructed the splenic artery with end-to-end anastomosis. Third one suffered from splenomegaly and portal hypertension. We performed splenectomy with the aneurysm. From the clinical and pathological findings, we concluded that an aneurysm in our first case was associated with arterial dysplasia, second with hemodynamic changes in parous women, and third with portal hypertension. Aneurysms of the splenic artery have been rarely reported until recently, when developments in diagnostic procedures made their discovery easier. We have diagnosed splenic artery aneurysm in three patients preoperatively. The clinical symptoms and operative procedure was different in each case, and are reported here. We demonstrated the summary of our three cases of that at Table 1.
我们最近治疗了三例脾动脉瘤,因此我们报告了这三例病例,并对日本的181例病例进行了回顾。所有三例均为女性,各有其独特的临床病程和发病机制,我们对其进行了合理的手术,使其得以挽救。第一例是破裂病例。因此,我们在阻断主动脉9分钟的情况下,从动脉瘤内部结扎脾动脉。第二例是在因胆囊切除术入院期间发现脾动脉瘤,因此我们进行了脾切除术和动脉瘤切除术,之后用端端吻合术重建脾动脉。第三例患有脾肿大和门静脉高压。我们对动脉瘤进行了脾切除术。根据临床和病理结果,我们得出结论,第一例中的动脉瘤与动脉发育异常有关,第二例与经产妇的血流动力学变化有关,第三例与门静脉高压有关。直到最近,随着诊断程序的发展使其更容易被发现,脾动脉瘤的报道还很少。我们术前诊断出三例脾动脉瘤患者。每例的临床症状和手术方式各不相同,在此报告。我们在表1中展示了这三例病例的总结。