Teneriello F L, Teneriello G F, Del Grande E, Della Casa U, Clazzer W, Borghese M, Anania F, Serracino Inglott F, Picchiotti R
Instituto di Clinica Chirurgica, P. Valdoni, Università degli Studi La Sapienza, Roma.
G Chir. 1997 Apr;18(4):222-8.
Nonparasitic cysts of the spleen are uncommon and often result from blunt abdominal trauma. Nonsurgical management of blunt splenic injuries increases the number of observations of the post-traumatic cysts. Complications (infection, rupture and hemorrhage) are lifethreatening, difficult to diagnose and require urgent surgical management. Until recently, splenectomy has been the primary choice of treatment of these cysts. Small (< 4 cm) asymptomatic post-traumatic pseudocysts stand a reasonable chance of involution with time (3-36 months) and so may be initially observed. Splenic preservation by partial splenectomy, enucleation or by marsupialization is actually recommended in children when technically feasible. Splenectomy is required for voluminous, central, multifocal cysts, in the presence of complications and in the adults with low immunologic risk. The Authors report 5 cases of large cysts successfully treated by splenectomy with one 12-year-old girl treated in emergency for infection by Salmonella.
脾脏非寄生虫性囊肿并不常见,常由腹部钝性外伤引起。钝性脾损伤的非手术治疗增加了创伤后囊肿的观察次数。并发症(感染、破裂和出血)危及生命,难以诊断,需要紧急手术治疗。直到最近,脾切除术一直是这些囊肿的主要治疗选择。较小(<4 cm)的无症状创伤后假性囊肿有合理的机会随着时间(3 - 36个月)自行消退,因此最初可进行观察。在技术可行的情况下,儿童实际上推荐通过部分脾切除术、囊肿摘除术或袋形缝合术来保留脾脏。对于巨大、位于中央、多灶性囊肿、存在并发症以及免疫风险较低的成年人,则需要进行脾切除术。作者报告了5例通过脾切除术成功治疗的大囊肿病例,其中一名12岁女孩因沙门氏菌感染接受了急诊治疗。