El-Kheir Alaa, Abdelnour M, Boutros Jihad G
Department of General and Digestive Surgery, Nini Hospital, Tripoli, Lebanon.
Department of Gastroenterology and Hepatology, Maritime Hospital, Jbeil, Lebanon.
Int J Surg Case Rep. 2019;58:63-66. doi: 10.1016/j.ijscr.2019.03.040. Epub 2019 Mar 30.
Splenosis, an autotransplantation of splenic tissues in another compartment of the body, is only symptomatic when hematologic diseases have recurred or compression of other adjacent structures have occurred. Therefore, we report a clinical case of a patient with bowel obstruction due to splenosis.
A patient with a history of splenectomy, presented to the emergency room for abdominal pain and obstipation, suggesting intestinal obstruction which is also seen on CT scan. During laparotomy, multiple splenic nodules were seen on the mesentery of the small bowel and colon, with vascular bridges between them, resulting in bowel obstruction. Resection of splenic nodules was performed. The post-operative course was uneventful and the patient was discharged a week after.
Although very rare, gastrointestinal symptoms may sometimes be described in patients with splenosis. Bleeding or obstruction can occur because of intramural grow or external compression, respectively. Treatment consists of resection of these nodules.
Splenosis should always be thought in patients with previous splenic rupture and presenting with incidental nodules seen on imaging, with further investigations when symptoms are present.
脾组织自体移植是指脾组织在身体的另一个腔隙中进行自体移植，只有在血液系统疾病复发或出现对其他相邻结构的压迫时才会出现症状。因此，我们报告一例因脾组织自体移植导致肠梗阻的临床病例。
一名有脾切除术病史的患者因腹痛和便秘到急诊室就诊，提示肠梗阻，CT扫描也显示了这一情况。在剖腹手术中，在小肠和结肠系膜上发现多个脾结节，它们之间有血管桥，导致肠梗阻。进行了脾结节切除术。术后过程顺利，患者一周后出院。
尽管非常罕见，但脾组织自体移植患者有时可能会出现胃肠道症状。分别可能由于壁内生长或外部压迫而发生出血或梗阻。治疗方法包括切除这些结节。
对于既往有脾破裂且影像学检查发现偶然结节的患者，应始终考虑脾组织自体移植，出现症状时应进一步检查。
