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[胸腹主动脉置换术中的脾损伤]

[Splenic Injury during Replacement of the Thoracoabdominal Aorta].

作者信息

Naganuma Masaaki, Takahashi Makoto, Terao Naoya, Takaya Hiroki, Watanabe Koyu, Suzuki Yusuke, Yoshioka Ichiro, Takahashi Goro, Akiyama Masatoshi, Kumagai Kiichiro, Adachi Osamu, Saiki Yoshikatsu

机构信息

Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.

出版信息

Kyobu Geka. 2019 Feb;72(2):104-107.

Abstract

Extraperitoneal approach is commonly employed for thoracoabdominal aortic repair via Stoney incision. It is supposedly rare to encounter abdominal visceral bleeding during that procedure. However, the spleen may spontaneously adhere to the adjacent peritoneum, which could induce incidental injury to the spleen by its anterior mobilization during extraperitoneal approach. Unless we bare its potential risk in mind, bleeding from the spleen may be overlooked, which results in hemodynamic deterioration. We have experienced 3 cases of splenic injury that necessitated hemostatic maneuvers for bleeding during and just after the thoracoabdominal aortic repair.

摘要

经腹膜外途径通常用于通过斯托尼切口进行胸腹主动脉修复。在该手术过程中遇到腹腔内脏出血的情况据推测很少见。然而,脾脏可能会自发地与相邻腹膜粘连,这可能会在经腹膜外途径向前游离脾脏时导致其意外损伤。除非我们牢记其潜在风险,否则脾脏出血可能会被忽视,从而导致血流动力学恶化。我们遇到了3例脾损伤病例,在胸腹主动脉修复期间及刚结束后需要对出血进行止血处理。

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