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无合并症患者的脾性紫癜破裂:一例病例报告。

Ruptured splenic peliosis in a patient with no comorbidity: A case report.

作者信息

Rhu Jiyoung, Cho Jinbeom

机构信息

Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.

出版信息

World J Clin Cases. 2020 Feb 6;8(3):535-539. doi: 10.12998/wjcc.v8.i3.535.

Abstract

BACKGROUND

Splenic peliosis is a disease characterized by widespread blood-filled cystic cavities within the parenchyma. Patients with this disease are usually asymptomatic; therefore, spontaneous or trauma-related rupture of the hemorrhagic cysts can occasionally cause life-threatening hemorrhagic shock.

CASE SUMMARY

A 51-year-old male patient with abdominal pain visited our emergency medical center two times with an interval of 2 mo. The patient was discharged from the hospital without treatment at his first visit; however, at the time of second admission, the hemoperitoneum with multiple cystic lesions of the spleen was found incidentally on the abdomen computed tomography scan. Since the patient was stable hemodynamically, a scheduled surgery was performed. The operative findings were consistent with splenic peliosis, and laparoscopic splenectomy was performed to prevent recurrent rupture of the hemorrhagic cysts.

CONCLUSION

Splenic peliosis is extremely rare, and we suggest splenectomy is necessarily required as a definite treatment for ruptured splenic peliosis to rescue patients with hemodynamic instability and to prevent recurrent rupture of hemorrhagic cysts in patients with stable hemodynamics.

摘要

背景

脾紫癜是一种以实质内广泛充满血液的囊性腔隙为特征的疾病。该疾病患者通常无症状;因此,出血性囊肿的自发性或与创伤相关的破裂偶尔会导致危及生命的失血性休克。

病例摘要

一名51岁男性患者因腹痛两次前往我们的急诊医疗中心,间隔为2个月。患者首次就诊时未接受治疗即出院;然而,第二次入院时,腹部计算机断层扫描偶然发现脾有多个囊性病变伴腹腔积血。由于患者血流动力学稳定,遂进行了择期手术。手术所见与脾紫癜相符,遂行腹腔镜脾切除术以防止出血性囊肿复发破裂。

结论

脾紫癜极为罕见,我们建议对于破裂的脾紫癜,脾切除术是必要的明确治疗方法,以挽救血流动力学不稳定的患者,并防止血流动力学稳定患者的出血性囊肿复发破裂。

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本文引用的文献

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