Stubbs M, Aryal Kr, Thomas E
James Paget University Hospital, Norfolk, UK.
J Surg Case Rep. 2012 Aug 1;2012(8):12. doi: 10.1093/jscr/2012.8.12.
Ectopic splenic tissue can present as accessory spleens and splenosis. While accessory spleens are congenital and more common; splenosis occurs as a result of implantation of splenic tissue as a result of trauma or iatrogenic injury. Only up to 40 intrathoracic splenosis have been reported in the English language literature to date. Here we discuss a case in which Para oesophageal pre-aortic ectopic splenic tissue was identified through radionuclide imaging 20 years after splenic rupture in a 44-year-old male for work up of epigastric pain. Splenosis should be considered as differential diagnosis in all previously splenectomised patients who present with unexplained masses on imaging. Early diagnoses with preoperative non-invasive radionucleotide scanning with collateral histories can prevent unnecessary surgery and reduce expensive and invasive investigations.
异位脾组织可表现为副脾和脾组织植入。副脾是先天性的,更为常见;脾组织植入是由于外伤或医源性损伤导致脾组织植入而发生的。迄今为止,英文文献中仅报道了40例胸腔内脾组织植入病例。在此,我们讨论一例44岁男性患者,在脾破裂20年后,因上腹部疼痛进行检查时,通过放射性核素成像发现食管旁主动脉前异位脾组织。对于所有既往行脾切除术且影像学检查发现不明原因肿块的患者,应将脾组织植入作为鉴别诊断考虑。通过术前无创放射性核素扫描及相关病史进行早期诊断,可避免不必要的手术,并减少昂贵且有创的检查。