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小儿脾脓肿行部分脾切除术成功的病例报告。

Case report of successful partial splenectomy for a splenic abscess in a paediatric patient.

作者信息

Ahmed Saleem, Oh Han Boon, Kheng Dale Lincoln Loh Ser, Krishnan Prabhakaran

机构信息

Department of Paediatric Surgery, Khoo Teck Puat - National University Children's Medical Institute, Singapore; Department of General Surgery, Tan Tock Seng Hospital, Singapore.

Department of Paediatric Surgery, Khoo Teck Puat - National University Children's Medical Institute, Singapore; University Surgical Cluster, National University Health System, Singapore.

出版信息

Int J Surg Case Rep. 2017;38:176-179. doi: 10.1016/j.ijscr.2017.07.050. Epub 2017 Jul 25.

Abstract

INTRODUCTION

Splenic abscess (SA) is a rare potentially fatal condition in the paediatric population. It is difficult to diagnose given its non-specific presentation. There are no current guidelines for management of SA in this population but splenic preservation is advantageous given the vital role the spleen plays in immunity.

PRESENTATION OF CASE

We present a case of a 15-year-old boy with a large splenic abscess. He underwent successful partial splenectomy with resolution of his symptoms thereafter.

DISCUSSION

Standard surgical treatment for splenic abscess is antibiotics and drainage. Spleen-preserving options include percutaneous drainage, partial splenectomy, subtotal splenectomy and splenic auto-transplantation. Spleen-preserving techniques should be used where possible to achieve best outcome in clearing infection and to ensure the immunologic role of the spleen is not compromised.

CONCLUSION

Splenic abscess is rare conditions seen in paediatric practice with high mortality and partial splenectomy can be a useful spleen-preserving technique in treating this condition.

摘要

引言

脾脓肿(SA)在儿科人群中是一种罕见的潜在致命疾病。鉴于其表现不具特异性,诊断较为困难。目前尚无针对该人群脾脓肿管理的指南,但鉴于脾脏在免疫中发挥的重要作用,保留脾脏是有益的。

病例介绍

我们报告一例15岁男孩患有巨大脾脓肿的病例。他接受了成功的部分脾切除术,术后症状得以缓解。

讨论

脾脓肿的标准外科治疗是抗生素和引流。保留脾脏的选择包括经皮引流、部分脾切除术、次全脾切除术和脾自体移植。应尽可能采用保留脾脏的技术,以在清除感染方面取得最佳效果,并确保脾脏的免疫功能不受损害。

结论

脾脓肿在儿科实践中是罕见疾病,死亡率高,部分脾切除术可能是治疗这种疾病的一种有用的保留脾脏技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c7/5536388/02fb269ff066/gr1.jpg

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