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产后患者脾破裂延迟就诊:游走脾病例

Delayed presentation of splenic laceration in a postpartum patient: a case of wandering spleen.

作者信息

Zayed Alaa, Samara Enas, Shubietah Abdalhakim, Awwad Ahmad, Zakaria Zaid, Daraghma Rawan, Hajhamad Mohammed

机构信息

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

Department of Internal Medicine, An-Najah National University Hospital, Nablus, Palestine.

出版信息

J Surg Case Rep. 2024 Aug 8;2024(8):rjae499. doi: 10.1093/jscr/rjae499. eCollection 2024 Aug.

Abstract

Wandering spleen (WS) is a rare condition where the spleen is abnormally mobile due to lax or poorly developed ligaments, leading to complications like torsion and laceration after trauma. We describe a case of a 31-year-old postpartum female who presented with severe abdominal pain following blunt trauma. Diagnostics showed an enlarged, ectopic spleen, and significant hematoma. Surgical exploration revealed a 10-cm splenic laceration, necessitating a splenectomy due to extensive blood loss and organ damage. This case highlights the challenges of diagnosing WS, particularly in postpartum patients with increased ligamentous laxity, emphasizing the need for vigilant monitoring and potentially preventive surgical measures to manage this complex condition effectively.

摘要

游走脾(WS)是一种罕见的病症,由于韧带松弛或发育不良,脾脏出现异常移动,导致创伤后发生扭转和撕裂等并发症。我们描述了一例31岁的产后女性病例,该患者在钝性创伤后出现严重腹痛。诊断显示脾脏肿大、异位,并有大量血肿。手术探查发现脾脏有10厘米的裂伤,由于大量失血和器官损伤,需要进行脾切除术。该病例凸显了游走脾诊断的挑战,尤其是在韧带松弛加剧的产后患者中,强调了有效管理这种复杂病症时进行密切监测和采取潜在预防性手术措施的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87e1/11308933/d9a21796acb4/rjae499f1.jpg

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