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急性腹痛的罕见病因:胰腺炎导致脾血肿及破裂。

A rare cause of acute abdomen: Splenic hematoma and rupture resulting from pancreatitis.

作者信息

Cengiz Fevzi, Yakan Savaş, Enver İlhan

机构信息

Clinic of 1 General Surgery, İzmir Bozyaka Training Hospital, İzmir, Turkey.

出版信息

Ulus Cerrahi Derg. 2013 May 28;29(2):81-3. doi: 10.5152/UCD.2013.20. eCollection 2013.

Abstract

Splenic subcapsular hematoma and splenic rupture due to pancreatitis are rare causes of acute abdomen. Here we report a case of splenic hematoma and rupture resulting from a second attack of pancreatitis in a 38 year-old woman with chronic pancreatitis due to alcoholism. Her first pancreatitis attack, 4 months before the second, was complicated with a pancreatic pseudocyst that was drained and acute renal failure. The patient underwent pancreatic necrosectomy and splenectomy, and was discharged on the sixth postoperative day without any further complication. We conclude that splenic hematoma, a complication of pancreatitis attack, which may require emergency surgical intervention, must be kept in mind in order to make an early diagnosis. Considering a possible subsequent attack of pancreatitis and determining follow-up criteria, radical treatment must be planned immediately.

摘要

胰腺炎导致的脾包膜下血肿和脾破裂是急性腹痛的罕见原因。在此,我们报告一例38岁因酒精中毒导致慢性胰腺炎的女性患者,其第二次胰腺炎发作引发了脾血肿和破裂。她的第一次胰腺炎发作在第二次发作前4个月,并发了胰腺假性囊肿,该囊肿已引流,同时还出现了急性肾衰竭。患者接受了胰腺坏死组织清除术和脾切除术,术后第六天出院,无任何进一步并发症。我们得出结论,脾血肿作为胰腺炎发作的一种并发症,可能需要紧急手术干预,为了早期诊断必须予以重视。考虑到胰腺炎可能随后再次发作并确定随访标准,必须立即制定根治性治疗方案。

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