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脾扭转:腹痛的罕见原因。

Splenic torsion: a rare cause of abdominal pain.

作者信息

Mohseni Michael, Kruse Brian T, Graham Charley

机构信息

Emergency Medicine, Mayo Clinic's Campus in Florida, Jacksonville, Florida, USA.

出版信息

BMJ Case Rep. 2018 Jul 18;2018:bcr-2018-224952. doi: 10.1136/bcr-2018-224952.

Abstract

Splenic torsion is an exceedingly rare but clinically important disease process that should be recognised promptly by the treating physician. In this condition, there is twisting of the spleen along its vascular pedicle, subsequently leading to abdominal pain in the setting of organ ischaemia. Vascular thrombosis and splenic infarction may ensue. Torsion has been described in cases of a known wandering spleen. Abnormal development of the splenic suspensory ligaments may predispose a patient to a wandering spleen. Treatment of splenic torsion is typically surgical, with goals of preservation of the spleen if possible.We present a case of a young woman who presented with left-sided chest and abdominal pain and was found to have splenic torsion with complete splenic infarction. Surgical intervention was required, and splenectomy was performed. In this case presentation, we outline the multidisciplinary approach needed to care for the patient with this rare condition.

摘要

脾扭转是一种极其罕见但临床上很重要的疾病过程,主治医生应迅速识别。在这种情况下,脾脏沿其血管蒂发生扭转,随后在器官缺血的情况下导致腹痛。继而可能发生血管血栓形成和脾梗死。已知游走脾的病例中曾有过扭转的描述。脾悬韧带发育异常可能使患者易患游走脾。脾扭转的治疗通常是手术治疗,目标是尽可能保留脾脏。我们报告一例年轻女性,她因左侧胸痛和腹痛就诊,被发现患有脾扭转并伴有完全性脾梗死。需要进行手术干预,遂行脾切除术。在本病例报告中,我们概述了照顾患有这种罕见疾病的患者所需的多学科方法。

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Splenic torsion: a rare cause of abdominal pain.脾扭转:腹痛的罕见原因。
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本文引用的文献

1
Wandering spleen presenting as small bowel obstruction.游走脾表现为小肠梗阻。
Am J Emerg Med. 2013 Jun;31(6):984-5. doi: 10.1016/j.ajem.2013.02.017. Epub 2013 May 13.
6
Splenic torsion: a case report.脾扭转:一例病例报告。
Ann R Coll Surg Engl. 2010 Jul;92(5):W51-2. doi: 10.1308/147870810X12699662980592. Epub 2010 Jun 7.
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Video. Hand-assisted laparoscopy for wandering spleen.视频。游走脾的手助腹腔镜手术。
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Acute torsion of a wandering spleen: imaging findings.游走脾急性扭转:影像学表现
Abdom Imaging. 2004 Nov-Dec;29(6):707-9. doi: 10.1007/s00261-004-0174-7. Epub 2004 Jun 8.

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