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游走脾扭转致胰尾受累后脾梗死在资源有限环境下的成功处理:一例报告

Splenic infarction following torsion of wandering spleen involving pancreatic tail successfully managed in resource limited setting: a case report.

作者信息

Gashaw Wubie Abel, Yirga Berhanu, Goedert Martha H

机构信息

Assistant Professor of General Surgery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Assistant Professor of General Surgery, Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia.

出版信息

J Med Case Rep. 2025 Jan 31;19(1):41. doi: 10.1186/s13256-024-05003-2.

Abstract

INTRODUCTION AND IMPORTANCE

Wandering spleen is a rare condition characterized by the extreme laxity or absence of ligaments that normally secure the organ in its anatomical position in the left upper quadrant. Torsion of a wandering spleen is an uncommon cause of acute abdominal pain and is rarely diagnosed preoperatively. Torsion involving the distal pancreas is even more unusual. Although patient presentations can be atypical, early diagnosis and prompt intervention can lead to successful outcomes.

CASE PRESENTATION

A 40-year-old Black female patient of Amhara ethnicity, from Ethiopia, presented with dull, aching abdominal pain and episodes of vomiting. After initial physiological stabilization and radiologic evaluation, laparotomy was performed, revealing torsion of a wandering spleen with involvement of the pancreatic tail, accompanied by adhesions of the small bowel and omentum. Following the release of adhesions, a splenectomy was performed. The patient was discharged in stable condition and continued to do well during follow-up visits.

CONCLUSION

Despite its rarity and potential for atypical presentations, a high index of suspicion for torsion of a wandering spleen is essential, particularly in patients with risk factors. With prompt diagnosis and timely intervention, patients with this condition can achieve favorable outcomes.

摘要

引言与重要性

游走脾是一种罕见病症,其特征是通常将脾脏固定于左上腹解剖位置的韧带极度松弛或缺失。游走脾扭转是急性腹痛的罕见原因,术前很少被诊断出来。涉及胰腺远端的扭转更为罕见。尽管患者表现可能不典型,但早期诊断和及时干预可带来成功的治疗结果。

病例介绍

一名40岁的阿姆哈拉族黑人女性患者,来自埃塞俄比亚,出现腹部隐痛和呕吐症状。在初步生理稳定和影像学评估后,进行了剖腹手术,发现游走脾扭转并累及胰尾,伴有小肠和网膜粘连。松解粘连后,进行了脾切除术。患者出院时情况稳定,随访期间持续恢复良好。

结论

尽管游走脾扭转罕见且可能表现不典型,但对其高度怀疑至关重要,尤其是对于有风险因素的患者。通过及时诊断和适时干预,患有这种病症的患者可取得良好的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5212/11786403/5f42a8e8f155/13256_2024_5003_Fig1_HTML.jpg

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