Chambon J P, Ribet M, Quandalle P, Guerrin F, Gosselin B, Gstach H, Pruvot F R
J Chir (Paris). 1987 Apr;124(4):253-7.
Splenic complications of chronic pancreatitis appear to be less exceptional than is usually accepted, particularly since preoperative diagnosis has been facilitated by ultrasound and abdominal scan imaging. Complications noted in 37 cases were: infarcts (2 cases), hematoma or false blood cysts (26 cases) and rupture (9 cases). The splenic infarcts were revealed by digestive hemorrhage, the false blood cysts of spleen by a painful mass in left hypochondrium associated with pleural effusion and rupture of spleen by an acute hemoperitoneum. Treatment included splenectomy in 19 cases, splenectomy caudal pancreatectomy in 17 cases and drainage of a splenic hematoma in one patient. Operative mortality was 16.2% and the long-term prognosis was poor and related to underlying condition. Data from an experimental study suggest that the effect of an episode of acute pancreatitis on the splenic pedicle is the most important physiopathologic factor. A hemorrhagic infarct or infarction of splenic parenchyma are common starting points for all clinicopathologic forms described.
慢性胰腺炎的脾脏并发症似乎比通常认为的更为常见，尤其是自从超声和腹部扫描成像有助于术前诊断以来。37例患者中发现的并发症有：梗死（2例）、血肿或假性血囊肿（26例）以及破裂（9例）。脾梗死表现为消化道出血，脾假性血囊肿表现为左季肋部疼痛性肿块伴胸腔积液，脾破裂表现为急性腹腔积血。治疗方法包括19例行脾切除术，17例行脾切除加胰尾切除术，1例患者行脾血肿引流术。手术死亡率为16.2%，长期预后较差且与基础疾病相关。一项实验研究的数据表明，急性胰腺炎发作对脾蒂的影响是最重要的病理生理因素。出血性梗死或脾实质梗死是所有所描述的临床病理形式的常见起始点。
