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儿童急性脾扭转:最佳治疗方法是什么?一例病例报告。

Acute splenic torsion in children: which is the best treatment? A case report.

作者信息

Cecchetto G, Dall'Igna P, Dalle Nogare C, Gasparella P, Zanon G F

机构信息

Pediatric Surgery Unit, Department of Pediatrics, University Hospital of Padua, Italy.

出版信息

Pediatr Med Chir. 2012 May-Jun;34(3):146-7. doi: 10.4081/pmc.2012.81.

Abstract

Wandering spleen is a clinical entity which rarely affects children and adolescents. This condition can be asymptomatic or responsible of chronic pain, but it appears as a surgical emergency when an acute twisting occurs. The risk of post-splenectomy sepsis in the pediatric population suggests a conservative approach whenever possible, and also in case of acute torsion, most authors prefer to preserve the spleen and perform a splenopexy. The Authors describe a case of a child with acute splenic torsion, in whom a conservative surgical approach was initially adopted. The conservative option has to be balanced with the risk of prolonged thrombocytopenia, multiple transfusions and a possible second procedure to remove the spleen.

摘要

游走脾是一种临床病症,很少影响儿童和青少年。这种情况可能无症状,也可能导致慢性疼痛,但当发生急性扭转时,则表现为外科急症。儿科人群中脾切除术后发生败血症的风险提示,只要有可能,应采取保守治疗方法,即使在急性扭转的情况下,大多数作者也倾向于保留脾脏并进行脾固定术。作者描述了一例急性脾扭转患儿的病例,最初采取了保守手术方法。保守选择必须与长期血小板减少、多次输血以及可能需要进行第二次脾脏切除手术的风险相权衡。

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