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以急性腹痛为表现的副脾梗死:一例报告

Accessory splenic infarction presenting as acute abdominal pain: A case report.

作者信息

Awad Dana, Khater Danielle Abou, Habchy Peter, Helou Mariana

机构信息

Emergency Medicine Department, Lebanese American University Medical Center, Beirut, Lebanon.

General Surgery Department, Lebanese American University Medical Center, Beirut, Lebanon.

出版信息

Int J Surg Case Rep. 2025 Feb;127:110852. doi: 10.1016/j.ijscr.2025.110852. Epub 2025 Jan 6.

Abstract

INTRODUCTION

Accessory spleens are a common anatomical variant, consisting of ectopic splenic tissue present in different locations in the peritoneal cavity. Typically asymptomatic, the presence of these tissue grows to be of clinical importance when complicated by infarction, rupture, or torsion.

PRESENTATION OF CASE

We report the case of a 36-year-old female that presented to the Emergency Department for diffuse abdominal pain and was found to have a partially ruptured splenule secondary to a venous infarct on abdominal computed tomography scan. The patient was admitted to the hospital for pain management and further workup. Her hospital stay was uncomplicated with complete resolution of symptoms after 5 days.

DISCUSSION

The usually asymptomatic accessory spleen can present in case of infarction with vague symptoms like abdominal pain, nausea, or vomiting. It is triggered by conditions such hematologic disorders, embolic disorders, vascular disorders, and trauma. Oral contraceptive pills increase thrombosis risk by affecting coagulation factors, making them a potential cause of infarction. Diagnosis typically involves CT imaging, and treatment ranges from supportive care to surgical intervention.

CONCLUSION

Accessory spleen infarction, although rare, is a diagnosis that should be considered in the assessment of a patient presenting to the emergency with acute abdominal pain.

摘要

引言

副脾是一种常见的解剖变异,由存在于腹腔不同位置的异位脾组织构成。通常无症状,当这些组织因梗死、破裂或扭转而出现并发症时,其存在就具有了临床意义。

病例介绍

我们报告一例36岁女性病例,该患者因弥漫性腹痛就诊于急诊科,腹部计算机断层扫描显示其脾小结因静脉梗死而部分破裂。患者入院接受疼痛管理及进一步检查。她住院期间病情无并发症,5天后症状完全缓解。

讨论

通常无症状的副脾在发生梗死时可能出现如腹痛、恶心或呕吐等模糊症状。其诱因包括血液系统疾病、栓塞性疾病、血管疾病和创伤等情况。口服避孕药通过影响凝血因子增加血栓形成风险,使其成为梗死的一个潜在原因。诊断通常涉及CT成像,治疗范围从支持治疗到手术干预。

结论

副脾梗死虽然罕见,但在评估因急性腹痛就诊于急诊科的患者时应考虑这一诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3847/11760800/b7d1920435a0/gr1.jpg

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