Reynolds M, Donaldson J S, Vogelzang R L
Department of Surgery, Children's Memorial Hospital, Northwestern University Medical Center, Chicago, IL.
J Pediatr Surg. 1989 Jul;24(7):700-1; discussion 701-2. doi: 10.1016/s0022-3468(89)80724-9.
Partial splenic arterial embolization was used to treat hypersplenism in a 10-year-old boy with portal hypertension secondary to congenital hepatic fibrosis. After embolization the spleen remained enlarged, but the boy's platelet count increased and his variceal bleeding ceased. One month later, he returned with vomiting and an abdominal mass. Computed tomography showed a large cyst of the spleen with a small rim of residual splenic tissue. Percutaneous drainage with ultrasound guidance yielded 2,800 mL of brown fluid. Wedge-shaped infarctions are described early after splenic embolization, and these areas eventually fibrose and contract. In this case, the embolization resulted in splenic necrosis and liquefaction with pseudocyst formation. This unusual complication was effectively treated without surgery.
采用部分脾动脉栓塞术治疗一名10岁患有先天性肝纤维化继发门静脉高压所致脾功能亢进的男孩。栓塞术后脾脏仍肿大，但男孩的血小板计数增加，曲张静脉出血停止。1个月后，他因呕吐和腹部肿块复诊。计算机断层扫描显示脾脏有一个大囊肿，周围有一小圈残留脾组织。在超声引导下经皮引流引出2800毫升棕色液体。脾栓塞术后早期可出现楔形梗死，这些区域最终会纤维化并收缩。在本病例中，栓塞导致脾坏死、液化并形成假性囊肿。这种不寻常的并发症未经手术即得到有效治疗。
