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脾切除术治疗与巨大海绵状脾血管瘤相关的卡萨巴赫-梅里特综合征:一位外科医生对一个罕见、鲜有人读但又复杂问题的反思——综述文章

Kasabach-Merritt Syndrome Associated With a Large Cavernous Splenic Hemangioma Treated With Splenectomy: A Surgeon's Introspection of an Uncommon, Little Read, and Yet Complex Problem-Review Article.

作者信息

Haque Parvez David, Mahajan Amit, Chaudhary Navneet Kumar, Jain Deepak

机构信息

Department of Surgery, Christian Medical College and Hospital, Ludhiana, 141008 Punjab India.

出版信息

Indian J Surg. 2015 Apr;77(Suppl 1):166-9. doi: 10.1007/s12262-015-1232-9. Epub 2015 Mar 24.

Abstract

Cavernous hemangiomas of the spleen are small benign lesions found incidentally, majority of times while patients are being investigated for some other disease and patients remain asymptomatic otherwise for this condition. The natural history of cavernous hemangiomas of spleen is slow, symptoms or complications, when present, occur late, they are rarely large and can manifest as a palpable non-tender mass in the left upper quadrant. A very rare syndrome is associated with this condition called Kasabach-Merritt syndrome (KMS), which is defined as diffuse cavernous hemangioma of the spleen alongwith anemia, thrombocytopenia, and coagulopathy. Perioperative diagnosis can be confirmed by imaging study which can be CT, MRI, or ultrasound. Splenectomy is considered the treatment of choice for such patients with symptoms. To our knowledge, a very few cases have been reported so far. The purpose of writing this review article is the reporting of this rare case and to provide some experience related to the management of this condition in a patient with KMS.

摘要

脾海绵状血管瘤是偶然发现的小的良性病变,大多数情况下是在患者因其他疾病接受检查时发现的,否则患者在这种情况下通常无症状。脾海绵状血管瘤的自然病程缓慢,症状或并发症如果出现,通常出现较晚,它们很少体积很大,可表现为左上腹可触及的无压痛肿块。一种非常罕见的综合征与这种情况相关,称为卡萨巴赫-梅里特综合征(KMS),其定义为脾脏弥漫性海绵状血管瘤伴贫血、血小板减少和凝血病。围手术期诊断可通过影像学检查确诊,影像学检查可以是CT、MRI或超声。脾切除术被认为是有症状患者的首选治疗方法。据我们所知,迄今为止报道的病例非常少。撰写这篇综述文章的目的是报告这一罕见病例,并提供一些在KMS患者中管理这种疾病的经验。

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