副脾、混合性裂孔疝、切口疝：一个复杂的多学科外科治疗病例。

IF 2 Q2 EMERGENCY MEDICINE

International Journal of Emergency Medicine Pub Date : 2025-06-20 DOI:10.1186/s12245-025-00917-0

Hamdah Hanifa, Mohi Alddin Moustafa Mahouk, Fadiah Hazem Albaroudi, Enas Saleem Khallouf, Dana Abu Nokta, Ranim Alrihani, Basil Alsaleh, Youssef Zeeb, Ramez Altair, Malek AlBalkhi, Rawad Asami, Abdullah Shekh Najjaren

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引用次数: 0

摘要

背景：副脾是由于胚胎发生过程中不完全融合而引起的，是腹部影像学检查中经常发现的发育异常。尽管手术进步，剖腹手术后切口疝仍然存在，而裂孔疝，常见于老年人，通常无症状。病例介绍：55岁男性，腹痛，慢性呕吐，消化道出血。评估显示混合性裂孔疝伴多副脾，需要手术干预。中线切口有助于粘连解除、疝修复和360度Nissen底吻合。术后，患者病情稳定，出院时给予流质饮食和药物治疗。组织病理学分析证实了良性的发现，强调了成功的复杂腹部疾病的处理。结论：对有复杂胃肠道症状和手术史的患者进行综合评估至关重要。准确的诊断和干预，包括副脾切除和疝修补，使临床显著增强，无并发症。

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Accessory spleens, mixed hiatal hernia, and incisional hernias: a complex case of multidisciplinary surgical management.

Background: Accessory spleens, arising from incomplete fusion during embryogenesis, are frequent developmental anomalies detected incidentally in abdominal imaging studies. Despite surgical advancements, post-laparotomy incisional hernias persist, while hiatal hernias, common in older adults, often present asymptomatically.

Case presentation: A 55-year-old male presented with abdominal pain, chronic vomiting, and gastrointestinal bleeding. Evaluation unveiled a mixed hiatal hernia alongside multiple accessory spleens, necessitating surgical intervention. A midline incision facilitated adhesion release, hernia repair, and a 360-degree Nissen fundoplication. Postoperatively, the patient stabilized, discharged with a liquid diet and medications. Histopathological analysis confirmed benign findings, emphasizing successful complex abdominal condition management.

Conclusion: Comprehensive assessment is vital for patients with intricate gastrointestinal symptoms and surgical histories. Accurate diagnosis and intervention, encompassing accessory spleen excision and hernia repair, resulted in notable clinical enhancement devoid of complications.

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来源期刊

International Journal of Emergency Medicine EMERGENCY MEDICINE-

CiteScore

4.60

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.