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游走脾病例报告

[A case report of wandering spleen].

作者信息

Giraud J-T, Dingremont C, Gailleton R, Tissier M, Arouch K

机构信息

Service de médecine interne, centre hospitalier de Bigorre, 65000 Tarbes, France.

Service de médecine interne, centre hospitalier de Bigorre, 65000 Tarbes, France.

出版信息

Rev Med Interne. 2021 Apr;42(4):285-287. doi: 10.1016/j.revmed.2020.11.010. Epub 2020 Dec 16.

Abstract

INTRODUCTION

Wandering spleen is a rare condition that occurs when there is an acquired or congenital hypelaxity of the suspensory ligaments of the spleen, resulting in its migration to any abdominal or pelvic position.

CASE REPORT

A 43-year-old woman presented with symptoms of acute abdominal pain. At physical examination, a splenomegaly was found in the left hypochondria, thereafter followed by a secondary migration of the lump to a periumbilical location. Computed tomography revealed a wandering spleen with vascular pedicle torsion. Splenopexia was perfomed.

CONCLUSION

A wandering spleen is most frequently observed in children and young women. This rare diagnosis should be considered facing a recurrent abdominal pain syndrome, a splenomegaly accompanied with pain, or a pelvic lump. A wandering spleen may lead to torsion of the vascular pedicle of the spleen, a chronic volvulus with portal hypertension, or even a splenic infarction. The diagnosis is performed by computed tomography. Wandering spleen is treated surgically, by splenopexy or splenectomy.

摘要

引言

游走脾是一种罕见的病症,发生于脾脏悬韧带出现后天性或先天性松弛时,导致脾脏迁移至腹部或盆腔的任何位置。

病例报告

一名43岁女性出现急性腹痛症状。体格检查时,在左季肋部发现脾肿大,随后肿块继发迁移至脐周位置。计算机断层扫描显示游走脾伴血管蒂扭转。实施了脾固定术。

结论

游走脾在儿童和年轻女性中最为常见。面对复发性腹痛综合征、伴有疼痛的脾肿大或盆腔肿块时,应考虑这一罕见诊断。游走脾可能导致脾血管蒂扭转、伴有门静脉高压的慢性肠扭转,甚至脾梗死。通过计算机断层扫描进行诊断。游走脾通过脾固定术或脾切除术进行手术治疗。

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