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上皮性脾囊肿与危及生命的脾破裂。

Epithelial splenic cysts and life-threatening splenic rupture.

作者信息

Fragandreas G, Papadopoulos S, Gerogiannis I, Spyridis C, Tsantilas D, Venizelos I, Gerasimidis T

机构信息

5th Department of Surgery, "Hippokrateion" General Hospital, Aristotle University of Thessaloniki, Greece.

出版信息

Chirurgia (Bucur). 2011 Jul-Aug;106(4):519-22.

Abstract

BACKGROUND/AIM: Primary splenic cysts are relatively uncommon and in the majority of cases are classified as epithelial cysts which are more frequent in young patients. Most of them are asymptomatic, and they are found incidentally during imaging techniques or laparotomy. We report two rare cases of patients with epithelial splenic cysts as an incidental finding during emergency laparotomy for splenic rupture.

MATERIALS AND METHOD

The first patient was a 70-year-old man who presented with symptoms of acute abdomen after intensive cough during an episode of asthma. Emergency laparotomy findings were splenic rupture and intraperitoneal haemorrhage. A splenectomy was performed and the histological examination showed a ruptured spleen with an epithelial cyst. The second patient was a 19-year-old man who was transferred to the Emergency Department in hypovolemic shock due to intraperitoneal bleeding after a blunt abdominal injury. During laparotomy a splenic rupture was found, and an epithelial cyst.

CONCLUSION

Epithelial splenic cysts are a rare entity and they can be an incidental finding during the surgical treatment of a spleen rupture and haemoperitoneum. These cysts may be a predisposing factor to splenic rupture in cases of increased intraabdominal pressure or blunt abdominal trauma.

摘要

背景/目的:原发性脾囊肿相对少见,在大多数情况下被归类为上皮性囊肿,在年轻患者中更为常见。大多数患者无症状,在影像学检查或剖腹手术中偶然发现。我们报告两例罕见的上皮性脾囊肿患者,均在因脾破裂行急诊剖腹手术时偶然发现。

材料与方法

首例患者为一名70岁男性,在哮喘发作期间剧烈咳嗽后出现急腹症症状。急诊剖腹手术发现脾破裂和腹腔内出血。行脾切除术,组织学检查显示脾脏破裂并伴有上皮性囊肿。第二例患者为一名19岁男性,因钝性腹部损伤后腹腔内出血导致低血容量性休克被送至急诊科。剖腹手术时发现脾破裂及一个上皮性囊肿。

结论

上皮性脾囊肿是一种罕见疾病,可在脾破裂和腹腔积血的手术治疗过程中偶然发现。在腹内压升高或钝性腹部创伤的情况下,这些囊肿可能是脾破裂的诱发因素。

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