Patil Pradeep V, Khalil Ahmed, Thaha Mohamed A
Department of Surgery, Ninewells Hospital and Medical School, Dundee, UK.
JOP. 2011 May 6;12(3):287-91.
The close proximity of splenic hilum to the tail of pancreas makes it vulnerable to complications in both acute and chronic pancreatitis. In this article, we examine the clinical course of these potentially fatal complications.
Citing three clinical cases, we present the spectrum of splenic complications in pancreatitis and explore the anatomical causal relationships and pathological basis of such complications. A literature review was carried out to inform on the incidence, morbidity and mortality rates, and clinical course especially diagnostic and management options for these patients. The spectrum of splenic complications in pancreatitis is wide ranging from pseudo cysts to haematomas, haemorrhages, infarctions and life threatening splenic rupture. Although a contrast enhanced helical CT scan is the investigation of choice a high index of clinical suspicion is essential in their early identification. Splenic complications in pancreatitis incur a high morbidity (79%) and a significant mortality (8%).
Splenic parenchymal complications in pancreatitis are an increasingly recognised entity and should be suspected in patients with inflammation and or necrosis involving the tail of pancreas. Conservative management is feasible with close radiological monitoring for most patients in a tertiary referral centre with appropriate expertise and surgery may be reserved for haemodynamically unstable patients.
脾门与胰尾紧邻，这使得其在急性和慢性胰腺炎中都易发生并发症。在本文中，我们研究了这些潜在致命并发症的临床病程。
引用三个临床病例，我们展示了胰腺炎中脾并发症的范围，并探讨了此类并发症的解剖学因果关系和病理基础。进行了文献综述，以了解这些患者的发病率、患病率和死亡率，以及临床病程，尤其是诊断和管理方案。胰腺炎中脾并发症的范围广泛，从假性囊肿到血肿、出血、梗死以及危及生命的脾破裂。尽管增强螺旋CT扫描是首选的检查方法，但高度的临床怀疑对于早期识别至关重要。胰腺炎中的脾并发症发病率高（79%）且死亡率显著（8%）。
胰腺炎中的脾实质并发症是一个越来越被认识到的实体，对于胰腺尾部有炎症和/或坏死的患者应予以怀疑。在拥有适当专业知识的三级转诊中心，对大多数患者进行密切的放射学监测，保守治疗是可行的，而对于血流动力学不稳定的患者可能需要进行手术。
