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游走脾的故事:脾脏扭转1800度伴梗死及肝脏继发性受累。

Tale of a wandering spleen: 1800 degree torsion with infarcted spleen and secondary involvement of liver.

作者信息

Maksoud Safia F A, Swamy Nayanatara, Khater Nivan Hany

机构信息

Faculty of Medicine, Zagazig university, Egypt.

Department of Clinical Radiology, Al Sabah Hospital, Kuwait.

出版信息

J Radiol Case Rep. 2014 Jun 30;8(6):18-26. doi: 10.3941/jrcr.v8i6.1534. eCollection 2014 Jun.

Abstract

Wandering spleen is a rare clinical entity characterized by splenic hypermobility resulting from laxity or maldevelopment of the suspensory splenic ligaments. The spleen can "wander" or migrate into various positions within the abdomen or pelvis due to this ligamentous laxity. It is usually detected between 20 and 40 years of age, and is more common in women. The clinical presentation of a wandering spleen is variable, it could present as an asymptomatic, incidentally detected, abdominal or pelvic mass, or as an acute abdomen secondary to splenic torsion. Diagnosis in an emergent setting can be challenging as it is a rare cause of acute abdomen and does not produce any symptoms until splenic torsion has occurred. We present and discuss a case of ectopic, torsed spleen resulting in complete infarction of the spleen and severe hepatic vascular compromise, diagnosed by ultrasound, confirmed by computed tomography and effectively managed by splenectomy.

摘要

游走脾是一种罕见的临床病症,其特征是由于脾悬韧带松弛或发育不良导致脾脏活动过度。由于这种韧带松弛,脾脏会“游走”或迁移至腹部或盆腔内的不同位置。它通常在20至40岁之间被发现,在女性中更为常见。游走脾的临床表现多样,可表现为无症状、偶然发现的腹部或盆腔肿块,或因脾扭转继发的急腹症。在紧急情况下进行诊断具有挑战性,因为它是急腹症的罕见病因,在脾扭转发生之前不会产生任何症状。我们呈现并讨论了一例异位、扭转的脾脏导致脾脏完全梗死和严重肝血管受压的病例,该病例通过超声诊断,计算机断层扫描证实,并通过脾切除术得到有效治疗。

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