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游走脾扭转:一项诊断挑战。

Wandering Spleen Torsion: A Diagnostic Challenge.

作者信息

Eleiwi Malak, Atatri Yazid, Younis Omar, Zuhd Jehad, Awadghanem Ahmed, Qashoo Ahmad, Sholi Suha, Bustame Samer

机构信息

Medicine, An-Najah National University Hospital, Nablus, PSE.

Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE.

出版信息

Cureus. 2024 Feb 4;16(2):e53552. doi: 10.7759/cureus.53552. eCollection 2024 Feb.

Abstract

Wandering spleen, or hypermobile spleen, arises from the elongation or maldevelopment of the spleen's suspensory ligaments. This condition is a rare clinical entity, primarily affecting children, with a higher prevalence among adult females in the active reproductive age group. Manifestations may include an asymptomatic abdominal mass or intermittent abdominal discomfort due to the torsion and subsequent spontaneous detorsion of the spleen. This case report details the presentation of a 14-year-old female initially misdiagnosed as having gastroenteritis who later experienced acute abdomen. Subsequent ultrasonography and computed tomography scan revealed splenic torsion, confirmed during exploratory laparotomy, which demonstrated an infarcted spleen. The definitive therapeutic intervention was a total splenectomy. This clinical entity should be taken into account in the differential diagnosis of acute abdominal pain in order to aid in early diagnosis and management. This could allow us to avoid splenectomy whenever possible and instead do splenopexy, especially in pediatric cases, as the spleen plays a crucial role in the reticuloendothelial system.

摘要

游走脾,又称活动脾,是由脾悬韧带延长或发育异常引起的。这种情况是一种罕见的临床病症,主要影响儿童,在育龄期成年女性中患病率较高。其表现可能包括无症状腹部肿块,或因脾脏扭转及随后的自行解转而出现间歇性腹部不适。本病例报告详细介绍了一名14岁女性患者,最初被误诊为肠胃炎,后来出现急腹症。随后的超声检查和计算机断层扫描显示脾扭转,剖腹探查术中得到证实,术中可见梗死的脾脏。最终的治疗干预措施是全脾切除术。在急性腹痛的鉴别诊断中应考虑到这种临床病症,以有助于早期诊断和治疗。这可以使我们尽可能避免脾切除术,转而进行脾固定术,尤其是在儿科病例中,因为脾脏在网状内皮系统中起着至关重要的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ae/10913703/c6152d4f07f5/cureus-0016-00000053552-i01.jpg

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