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腹腔镜下脾动脉瘤切除术。

Laparoscopic excision of splenic artery aneurysm.

作者信息

Kim Youngjin, Johna Samir

机构信息

Department of General Surgery, Arrowhead Regional Medical Center, Fontana, CA 92335, USA.

出版信息

JSLS. 2013 Jan-Mar;17(1):132-4. doi: 10.4293/108680812X13517013317392.

Abstract

INTRODUCTION

Splenic artery aneurysm is more frequently diagnosed today with the advancement and liberal use of imaging modalities. A symptomatic aneurysm, an aneurysm of any diameter in a pregnant woman or a woman of childbearing age, and an aneurysm >2 cm are all strong indications for surgery because of a significantly increased risk for splenic artery rupture.

CASE DESCRIPTION

A 35-year-old, morbidly obese, African American woman presented with constant left flank pain for 4 weeks. Angiography confirmed a 2.5-cm splenic artery aneurysm near the splenic hilum. Because angioembolization was unlikely to succeed because of extensive collaterals and the aneurysm's proximity to the splenic hilum, laparoscopic excision of the aneurysm with splenectomy was performed.

DISCUSSION

We report the successful laparoscopic surgical treatment of a 2.5-cm splenic artery aneurysm. Any splenic artery aneurysm with a significantly increased risk of rupture requires a prompt intervention. Although percutaneous embolization of the splenic artery is the most frequently applied therapy today, surgical repair is preferred for all symptomatic aneurysms because of the greater likelihood of success.

摘要

引言

随着成像技术的进步和广泛应用,脾动脉瘤如今更常被诊断出来。有症状的动脉瘤、孕妇或育龄期女性的任何直径的动脉瘤以及直径>2cm的动脉瘤,由于脾动脉破裂风险显著增加,均是手术的强烈指征。

病例描述

一名35岁、病态肥胖的非裔美国女性因持续左侧胁腹疼痛4周前来就诊。血管造影证实脾门附近有一个2.5cm的脾动脉瘤。由于存在广泛的侧支循环且动脉瘤靠近脾门,血管栓塞不太可能成功,因此进行了腹腔镜下动脉瘤切除并脾切除术。

讨论

我们报告了一例成功的腹腔镜手术治疗2.5cm脾动脉瘤的病例。任何破裂风险显著增加的脾动脉瘤都需要及时干预。尽管经皮脾动脉栓塞是目前最常用的治疗方法,但由于手术成功率更高,所有有症状的动脉瘤首选手术修复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e268/3662731/71dd43c15c8e/jls0011329690001.jpg

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