Liu Jian, Feng Yanyu, Li Ang, Liu Chunqing, Li Fei
Department of General Surgery, Xuanwu Hospital, Capital Medical University, Number 45, Changchun Street, Beijing 100053, China.
Department of General Surgery, Daxing Teaching Hospital, Capital Medical University, Number 26, Huangcun West Street, Beijing 102600, China.
Gastroenterol Res Pract. 2019 Jan 28;2019:5827694. doi: 10.1155/2019/5827694. eCollection 2019.
Atraumatic splenic rupture (ASR) is rare but life threatening. In this study, we retrospectively described our experience on the diagnosis and treatment of 8 patients (male: 6; female: 2; mean age: 49.6) with ASR. ASR accounted for 3.2% (8/251) of the splenic ruptures. The clinical presentation of ASR was similar to traumatic splenic rupture (TSR). The sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in ASR diagnosis was 57.1% and 85.7%, respectively. According to the classification of the American Association for the Surgery of Trauma (AAST), 2 cases were classified as grade II splenic ruptures, 4 cases were classified as grade III ruptures, 1 case was classified as grade IV rupture, and 1 case was not classified. All the spleens became swollen, and hematomas were observed in 6 patients. Total splenectomy was recommended in most cases. At least 62.5% (5/8) of the patients with 7 etiological factors belonged to "atraumatic-pathological splenic rupture." Local inflammation and cancer were the most common etiological factors.
非创伤性脾破裂（ASR）虽罕见但危及生命。在本研究中，我们回顾性描述了8例非创伤性脾破裂患者（男性6例；女性2例；平均年龄49.6岁）的诊断和治疗经验。非创伤性脾破裂占脾破裂的3.2%（8/251）。非创伤性脾破裂的临床表现与创伤性脾破裂（TSR）相似。超声和增强计算机断层扫描（CECT）对非创伤性脾破裂诊断的敏感性分别为57.1%和85.7%。根据美国创伤外科协会（AAST）的分类，2例为Ⅱ级脾破裂，4例为Ⅲ级破裂，1例为Ⅳ级破裂，1例未分类。所有脾脏均肿大，6例患者观察到血肿形成。大多数病例建议行全脾切除术。7种病因中至少62.5%（5/8）的患者属于“非创伤性病理性脾破裂”。局部炎症和癌症是最常见的病因。
