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单孔腹腔镜脾切除术及脾自体移植治疗游走脾肿大伴扭转

Single-incision laparoscopic splenectomy and splenic autotransplantation for an enlarged wandering spleen with torsion.

作者信息

Katsura Shunsaku, Kawamura Daichi, Harada Eijiro, Enoki Tadahiko, Hamano Kimikazu

机构信息

Division of Pediatric Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of medicine, Ube, Yamaguchi, Japan.

Department of Surgery and Clinical Science, Yamaguchi University Graduate School of medicine, Ube, Yamaguchi, Japan.

出版信息

European J Pediatr Surg Rep. 2014 Jun;2(1):23-5. doi: 10.1055/s-0033-1357262. Epub 2013 Oct 10.

Abstract

A wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant, but instead is found in the lower abdomen or in the pelvic region because of the laxity of the peritoneal attachments. The unusually long pedicle is susceptible to twisting, which can lead to ischemia, and eventually to necrosis. We herein report a case of an enlarged wandering spleen with torsion, successfully treated by single-incision laparoscopic splenectomy and autotransplantation. The transplanted splenic tissues could be identified on a spleen scintigram obtained 3 months after the surgery. Howell-Jolly bodies were not observed in blood specimens. This procedure is able to prevent an overwhelming postsplenectomy infection, and leads to satisfactory cosmetic results.

摘要

游走脾是一种罕见的病症,脾脏不在左上腹,而是由于腹膜附着处松弛而位于下腹部或盆腔区域。异常长的脾蒂易发生扭转,可导致缺血,最终坏死。我们在此报告一例游走脾肿大伴扭转的病例,通过单切口腹腔镜脾切除术和自体移植成功治疗。术后3个月获得的脾脏闪烁扫描图上可识别出移植的脾组织。血液标本中未观察到豪-焦小体。该手术能够预防脾切除术后暴发性感染,并获得满意的美容效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/937f/4336060/14ee48b90f01/10-1055-s-0033-1357262-i130099cr-1.jpg

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