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关于妊娠期及产后游走脾患者的管理

About the management of patients with wandering spleen in pregnancy and postpartum.

作者信息

Daniela Brunialti, Sonia Prader

机构信息

Department of Gynecology and Obstetrics, Bressanone, Alto Adige, Italy.

出版信息

Arch Gynecol Obstet. 2025 Sep;312(3):991-996. doi: 10.1007/s00404-025-08009-3. Epub 2025 Jun 24.

Abstract

PURPOSE

This study aimed to review the literature with regard to the management and outcome in pregnant and postpartum females with wandering spleen.

METHODS

The literature was reviewed for articles regarding the following search terms: 'pregnancy', 'postpartum', 'torsion' and 'wandering spleen'.

RESULTS

17 articles were found in medical literature from 1907 to 2022. Case reports were divided up into 2 groups: antepartum group that counts 12 articles and the postpartum group with 5 articles. The median age of these females was 28 years. All patients had symptoms across both groups: abdominal pain (n=13), vomiting (n=5), thrombocytopenia (n=4), nausea (n=3) and thrombocytosis (n=2). 16 patients underwent splenectomy and 1 pregnant woman received conservative management during pregnancy. 15 patients had no post-operative complications. 1 woman had an incomplete abortion in the 1 st trimester and 1 female a stillbirth in the 3 rd trimester.

CONCLUSION

Wandering spleen in pregnancy and in puerperium is a rare condition with many different possible manifestations. Up to now literature has favored laparoscopic or open splenectomy as treatment for it. From asymptomatic patients to urgent and emergent cases, the diagnosis of a wandering spleen must be included when a pregnant or postpartum woman complains about an abdominal palpable mass and recurrent abdominal pain.

摘要

目的

本研究旨在回顾有关游走脾的妊娠和产后女性的管理及结局的文献。

方法

对文献进行检索,查找包含以下检索词的文章:“妊娠”、“产后”、“扭转”和“游走脾”。

结果

在1907年至2022年的医学文献中发现了17篇文章。病例报告分为两组:产前组12篇文章,产后组5篇文章。这些女性的中位年龄为28岁。两组所有患者均有症状:腹痛(n = 13)、呕吐(n = 5)、血小板减少(n = 4)、恶心(n = 3)和血小板增多(n = 2)。16例患者接受了脾切除术,1例孕妇在孕期接受了保守治疗。15例患者无术后并发症。1名女性在孕早期发生不全流产,1名女性在孕晚期发生死产。

结论

妊娠和产褥期游走脾是一种罕见疾病,有许多不同的可能表现。迄今为止,文献支持将腹腔镜或开放性脾切除术作为其治疗方法。从无症状患者到急症和紧急病例,当妊娠或产后女性主诉腹部可触及肿块和反复腹痛时,必须考虑游走脾的诊断。

相似文献

1
About the management of patients with wandering spleen in pregnancy and postpartum.关于妊娠期及产后游走脾患者的管理
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本文引用的文献

1
Wandering spleen, which is torsioned with the distal pancreas.游走脾,与远端胰腺一起扭转。
Ulus Travma Acil Cerrahi Derg. 2022 Sep;28(9):1363-1365. doi: 10.14744/tjtes.2021.34288.
2
Wandering spleen: a surgical enigma.游走脾:一个外科难题。
Gastroenterol Rep (Oxf). 2017 Aug;5(3):241-243. doi: 10.1093/gastro/gov034. Epub 2015 Aug 3.
4
Benefits and risks of splenectomy.脾切除术的利弊。
Int J Surg. 2014;12(2):113-9. doi: 10.1016/j.ijsu.2013.11.017. Epub 2013 Dec 3.
8
Wandering spleen.
Saudi J Gastroenterol. 2004 Jan;10(1):1-7.

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