Touloukian R J, Seashore J H
J Pediatr Surg. 1987 Feb;22(2):135-7. doi: 10.1016/s0022-3468(87)80430-x.
Splenic pseudocysts have traditionally required splenectomy because of the risks imposed by partial splenectomy or excision of the cyst lining. During the past 2 years, a 6-year-old boy and a 9-year-old girl presenting with vague upper abdominal discomfort, palpable splenomegaly, and a large unilocular sonolucent cyst within the spleen, were treated by partial splenic decapsulation with preservation of the hilar blood supply. This procedure involves mobilizing the spleen by dividing the renal, colic, and diaphragmatic attachments; decompressing the liquefied cyst contents through a thoracostomy trochar; excising the outer splenic capsule and gaining hemostasis of the splenic wall with a running interlocked silk suture; and providing external tube drainage of the left upper quadrant. During the follow-up period of 26 and 12 months, splenic size has returned to normal. Serial nuclear scan and ultrasound show a small residual crescent-shaped deformity of the functioning splenic remnant. We conclude that partial splenic decapsulation for splenic pseudocyst is simpler and safer than other preservation procedures attempted, and carries no increased risk of recurrence from leaving a portion of the pseudocyst wall.
传统上，由于部分脾切除术或囊肿内衬切除术存在风险，脾假性囊肿一直需要进行脾切除术。在过去两年中，一名6岁男孩和一名9岁女孩因上腹部隐痛、可触及脾肿大以及脾脏内有一个大的单房性无回声囊肿前来就诊，他们接受了保留脾门血供的部分脾被膜剥除术。该手术包括通过分离肾、结肠和膈的附着点来游离脾脏；通过胸腔穿刺套管针排出液化的囊肿内容物；切除脾脏外层被膜并用连续锁边丝线缝合脾壁止血；以及对左上腹进行外置引流管引流。在26个月和12个月的随访期内，脾脏大小已恢复正常。连续的核素扫描和超声检查显示，功能性脾残余有一个小的残留新月形畸形。我们得出结论，对于脾假性囊肿，部分脾被膜剥除术比其他尝试的保留手术更简单、更安全，并且不会因留下部分假性囊肿壁而增加复发风险。
