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脾破裂脾脏切除术后异位脾种植15例诊治经验 被引量:14

Ectopic Splenic Autotransplantation after splenic rupture and splenic resection: our experience in 15 patients
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摘要 目的 探讨脾破裂脾脏切除术后异位脾组织种植的临床特点并总结诊治体会.方法 回顾性分析1998年1月至2013年1月郑州人民医院收治的15例脾破裂脾脏切除术后异位脾组织种植患者的临床资料.结果 15例患者中,2例小肠异位种植并粘连行部分小肠切除术;5例大网膜种植行大网膜部分或全部切除术;4例肠系膜种植行局部肿物切除术;盆腔异位3例行左侧输卵管并肿物切除术2例,盆腔肿物切除术1例;多发异位脾种植3例;仅有l例肠系膜肿物经腹腔镜探查活检确诊,避免了开腹手术.结论 脾破裂脾脏切除术后异位脾组织种植是一种术后并发症.由于其临床表现不具特征性,易与腹腔恶性肿瘤混淆,诊断应结合病史及磁共振表现或99mTc标记的热变性红细胞检查,或行腹腔镜探查活检诊断. Objective To study the clinical characteristics and to summarize our experience in the diagnosis and treatment of ectopic splenic autotransplantation (ESAP) many years after splenic rupture and splenectomy.Methods The clinical data of 15 patients with ESAP who were treated in the People's Hospital of Zhengzhou from January 1998 to January 2013 were retrospectively analyzed.Results Of the 15 patients,2 patients presented with intestinal obstruction due to the ectopic splenic tissues and required partial resection of small intestine.In 5 patients,the ectopic splenic tissues were in the greater omentum which required resection of part or the whole of the greater omentum.In 4 patients,the ectopic splenic tissues were in the mesentery which required partial or total resection of the tissues.The ectopic tissues were in the pelvis in 3 patients and resection of the left fallopian tube was carried out in 2 patients and resection of the pelvic tissues in 1 patient.In 1 patient the diagnosis was made under laparoscopic biopsy,thus avoiding open surgery.Three patients had multiple implanted sites for these ectopic splenic tissues.Conclusions ESAP is an uncommon disease and it has no clinical characteristics.It is easy to confuse the condition with metastatic deposits.A diagnosis could be made only by combining the history with magnetic resonance imaging,or 99mTc study of red blood cells,or laparoscopic exploration and biopsy.
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2014年第8期587-589,共3页 Chinese Journal of Hepatobiliary Surgery
关键词 脾破裂 脾切除术 异位脾种植 诊断 治疗 Spleen Rupture Spleenectomy Ectopic splenic autotransplantation Diagnosis Therapy
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