脾动脉瘤的手术治疗特点(附1例报告及文献复习)

Q4 Medicine
Y. Orel, H. Y. Orel, Yuriy Z. Khorkavyi, Oleg M. Slabyy
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引用次数: 0

摘要

尽管发病率很低,但脾动脉瘤在所有内脏动脉瘤中占主导地位,育龄妇女发病率较高。考虑到大多数无症状的病程和因其破裂而死亡的高风险,及时诊断和正确的治疗策略仍然极其重要。关于这种病理患者手术治疗策略的选择问题仍然存在争议。目标。脾动脉瘤的临床病例、诊断和手术治疗的改进。临床病例。女性患者G.,32岁,主诉左疑病症周期性疼痛,门静脉海绵状变形背景下的门静脉高压症状,食管静脉反复出血史,脾功能亢进,入院时诊断为巨大脾动脉瘤(直径8x5cm)。该患者符合N.Roth的开放性手术和动脉瘤切除、脾切除和自体脾移植的条件。术后第7天发生反应性胰腺炎,使手术变得复杂,保守治疗成功。在未来,这门课程并不起眼。远程随访持续了两年,没有发现动脉瘤复发。进行的免疫印迹显示正常结果。结论及时的诊断使建立正确的诊断、合理的治疗策略和预防致命并发症成为可能。在某些情况下,开放手术干预仍然是治疗这种病理的首选方法。自体脾脏移植显示出良好的长期效果,可以在这类患者中进行,以预防免疫缺陷状态。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Features of Surgical Treatment of Patients with Splenic Artery Aneurysms (Case Report and Literature Review)
Despite the insigniϐicant prevalence, aneurysms of the splenicartery take a dominant share among all visceral aneurysms with a predominance of morbidity in women of childbearing age. Taking into account the mostly asymptomatic course and the high risk of mortality due to its rupture, timely diagnosis and correct treatment strategy remain extremely important. Questions regarding the choice of surgical treatment tactics for patients with this pathology remain debatable. The aim. Demonstration of a clinical case, improvement of diagnosis andsurgical treatment of patients with splenic artery aneurysms. Clinical case. Female patient G., 32 years old, with complaints of periodic pain in the left hypochondrium, signs of portal hypertension against the background of cavernous transformationof the portal vein, history of recurrent bleeding from the esophageal veins, hypersplenism admitted with a pre-diagnosed aneurysm of the splenic artery of giant dimensions (diameter 8x5 cm). The patient was qualified for open surgery and aneurysm resection with splenectomy and spleen autotransplantation by N. Roth. The postoperative period was complicated by the occurrence of reactive pancreatitis on day 7, which was successfully treated conservatively. In the future, the course was unremarkable. The remote follow-up lasted two years, and no recurrence of the aneurysm was detected. The performed immunogram showed normal results. Conclusion. The timely diagnosis makes it possible to establish the correct diagnosis, justify the treatment tactics and prevent fatal complications. Open surgical intervention in somecases remains the method of choice in the treatment of this pathology. Autotransplantation of the spleen has shown good long-term results and can be performed in patients of this category for the prevention of immunodeficiency states.
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来源期刊
CiteScore
0.20
自引率
0.00%
发文量
42
审稿时长
6 weeks
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