Abdominal peritoneal splenosis (clinical case)

S. A. Zvezda, R. I. Tamrazov, N. M. Fedorov, L. N. Komarova, E. M. Frank, D. G. Dimitriadi, R. D. Novikov, D. S. Butenko, S. I. Gudz
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Abstract

Background. Splenosis, or heterotopic autotransplantation of spleen tissue, is a benign disease, occurring in patient after splenectomy. This formation demands correct differential diagnosis because it is often diagnosed as a tumor. Main methods of splenosis diagnosis are ultrasound inspection, CT, MRI, but detailed anamnesis is also important to set the correct diagnosis. The clinical case in this report is aimed to show importance of timely and correct diagnosis which will allow to avoid unnecessary invasive diagnostic procedures, late diagnosis and decreasing of medical assistance quality. Clinical case. patient 61 y. o. is suspected on a tumor in left iliac region. He noted the trauma after falling on a back. The inspection was performed: CT of iliac region showed formation in the small intestines. Splenectomy was carried out 20 years ago. The patient is set to the clinical medical center “Medicinsky gorod” to a surgeon-oncologist. physical examination and laboratory analysis showed no pathological changes. CT of abdominal organs showed formation with regular edges. MRI of pelvic organs with contrast agent showed formation accumulating contrast irregularly. Control CT of abdominal organs showed no increasing of formation size. Conclusion. Abdominal splenosis is a benign disease, occurring after spleen tissue implantation in the abdominal cavity after spleen trauma or splenectomy. Splenosis course is usually asymptomatic and it is often diagnoses as a peritoneal canceromatosis mistakenly. Splenosis has to be included in the differential diagnosis in patients with trauma or splenectomy in anamnesis.
腹膜脾肿大(临床病例)
背景。脾病或脾组织异位自体移植是一种良性疾病,多发于脾切除术后的患者。这种疾病的形成需要正确的鉴别诊断,因为它常常被诊断为肿瘤。脾脏病诊断的主要方法是超声波检查、CT、核磁共振成像,但详细的病史也是正确诊断的重要依据。本报告中的临床病例旨在说明及时、正确诊断的重要性,这将避免不必要的侵入性诊断程序、晚期诊断和医疗援助质量的下降。临床病例:患者 61 岁,疑似左髂部肿瘤。他注意到背部摔伤。进行了检查:髂骨区 CT 显示在小肠内形成。20 年前进行过脾切除术。体格检查和实验室分析表明没有病理变化。腹部器官 CT 显示边缘整齐。使用造影剂进行的盆腔器官核磁共振成像显示,造影剂呈不规则聚集。腹部器官的对照 CT 显示癌灶没有增大。结论腹腔脾脏病是一种良性疾病,发生于脾脏外伤或脾脏切除术后脾脏组织植入腹腔。脾肿大通常无症状,常被误诊为腹膜癌肿。对于有外伤或脾切除病史的患者,脾病必须纳入鉴别诊断。
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