Kubo Hidemasa, Yamaoka Nobuki, Tamai Mizuki, Kamiya Hajime, Kamada Yosuke, Nagata Tomoyuki, Fukuda Ken-Ichiro, Otsuji Eigo
Department of Surgery, Kyoto Chubu Medical Center, 25 Yagi-Ueno, Yagi-cho, Nantan-shi, Kyoto, Japan.
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
Surg Case Rep. 2019 Feb 18;5(1):28. doi: 10.1186/s40792-019-0582-0.
Polysplenia refers to the presence of two or more equal-sized spleens. Very rarely, one of the multiple spleens may develop torsion and infarction.
A 21-year-old woman presented with left upper quadrant pain, the cause of which could not be diagnosed. She returned to our hospital, 2 days later, without any pain improvement. Enhanced computed tomography showed splenic infarction and polysplenia. Initially, we could not identify the cause of the infarction and started conservative therapy, which did not result in any improvement. Hence, we performed a splenectomy, after securing informed consent. Because the patient was a young woman, we opted for a laparoscopic approach. During surgery, we identified the cause of the infarction as spleen pedicle torsion; the infarcted spleen was excised using an automated suturing device. We completed the laparoscopic surgery without converting it to an open laparotomy, and the patient was discharged 4 days later. This was a rare case of polysplenia with splenic torsion.
Laparoscopic splenectomy is minimally invasive and has cosmetic advantages. Thus, this approach may be considered as a treatment option for this condition.
多脾症是指存在两个或更多大小相等的脾脏。非常罕见的是，多个脾脏中的一个可能会发生扭转和梗死。
一名21岁女性因左上腹疼痛就诊，病因无法确诊。两天后她回到我院，疼痛没有任何改善。增强计算机断层扫描显示脾梗死和多脾症。最初，我们无法确定梗死原因，于是开始进行保守治疗，但没有任何改善。因此，在获得知情同意后，我们进行了脾切除术。由于患者是年轻女性，我们选择了腹腔镜手术方式。手术中，我们确定梗死原因是脾蒂扭转；使用自动缝合装置切除了梗死的脾脏。我们完成了腹腔镜手术，未转为开腹手术，患者4天后出院。这是一例罕见的多脾症合并脾扭转病例。
腹腔镜脾切除术具有微创性和美观优势。因此，这种手术方式可被视为这种疾病的一种治疗选择。
