肾周副脾误诊为肾周血肿:1例报告并文献复习
|
摘要
脾脏切除术后残留的副脾可代偿性增大,由于副脾具有不定位性,可位于典型部位或不典型部位,容易引起误诊,有时还会造成不必要性的手术,给临床的诊疗增加了很高的难度。本文通过这个典型案例,探讨副脾的异位与其他相似疾病的诊断和治疗,诸如:肾上腺瘤、胰腺内副脾表皮样囊肿、右侧膈肌副脾误诊为肝脏肿瘤等相关疾病,进而增强临床医生对于副脾的认识和鉴别,为临床的诊断提供一个新的思路和经验。
The residual spleen after splenectomy can be compensated for enlargement. Because the accessory spleen is not located, it can be located in the typical part or atypical part. It is easy to cause misdiagnosis and sometimes cause unnecessary surgery. It has increased the difficulty of clinical diagnosis and treatment. Through this typical case, we discuss the common occupying sites of accessory spleen and the way of diagnosis and treatment, so as to enhance clinicians' understanding of accessory spleen and provide a new train of thought and experience for clinical diagnosis.
The residual spleen after splenectomy can be compensated for enlargement. Because the accessory spleen is not located, it can be located in the typical part or atypical part. It is easy to cause misdiagnosis and sometimes cause unnecessary surgery. It has increased the difficulty of clinical diagnosis and treatment. Through this typical case, we discuss the common occupying sites of accessory spleen and the way of diagnosis and treatment, so as to enhance clinicians' understanding of accessory spleen and provide a new train of thought and experience for clinical diagnosis.
引文
[1]吕琪,牛振英,刘志娟,等.再生脾的彩色多普勒超声表现与鉴别诊断[J].中国医学影像学杂志,2008,16(2):136-7.
[2]张菁,伍兵,庄宇,等.脾脏病变CT/MRI诊断进展[J].华西医学,2017,32(10):1606-10.
[3]Wang G,Chen P,Zong L.Accessory spleen arising from the gastric fundus mimicking gastrointestinal stromal tumor following splenectomy:a case report[J].Exp Ther Med,2014,7(2):349-51.
[4]彭俊红,刘松,周利华,等.特殊副脾的CT与MRI征象[J].世界华人消化杂志,2013,21(10):925-30.
[5]Pachowicz M,Mocarska A,Staros?awska E,et al.Accessory spleen mimicking pancreatic tumour:evaluation by 99mTc-labelled colloid SPECT/CT study.Report of two cases and a review of nuclear medicine methods utility[J].Folia Morphol(Praha),2015,74(4):532-9.
[6]Xu SY,Sun K,Xie HY,et al.Accessory spleen located in the right parietal peritoneum:The first case report[J].Medicine,2017,96(38):e7957-9.
[7]Zhou JS,Hu HP,Chen YY,et al.Rare presentation of a right retroperitoneal accessory spleen:A case report[J].Oncol Lett,2015,10(4):2400-2.
[8]LüYF,Han BB,Yu HL,et al.Accessory spleen appearing as an intrasplenic pseudo-tumoral mass:A rare case report[J].Oncol Lett,2015,10(2):982-4.
[9]侯卫华.副脾误诊为左肾上腺瘤超声表现1例[J].中国医学影像技术,2015,31(1):66-9.
[10]曹佑军,龚向阳,王建.肾上腺区副脾的CT表现[J].临床放射学杂志,2016,35(2):300-3.
[11]郭宇文,王文营,宋健,等.脾切除后副脾增大表现为左肾上腺假瘤一例报告并文献复习[J].国际外科学杂志,2015,42(8):539 -40,封4.
[12]杜宁,郭卫东,王祖森,等.胰腺内副脾表皮样囊肿1例并文献复习[J].中国普通外科杂志,2015,24(3):429-34.
[13]杨勇,杨军,丁亮,等.肝异位副脾误诊为右侧肾上腺占位性病变1例报道[J].中国普外基础与临床杂志,2016,23(8):907-10.
[14]葛红军,庄园,丁红,等.右侧膈肌副脾误诊为肝脏肿瘤1例[J].中国医学影像学杂志,2016,24(8):588-90.
[15]周长青.胰腺内异位副脾一例[J].临床放射学杂志,2017,36(05):713-4.
[16]Chan KJ,Fenton-Lee D.Intrapancreatic accessory spleen masquerading as a pancreatic neuroendocrine tumor[J].JGastrointest Surg,2018,22(10):1799-800.
[17]武文杰,李晓斌,吴文铭,等.胰腺内异位副脾的诊断[J].中华胰腺病杂志,2017,17(4):285-8.
[18]Ates I,Yazici O,Yazilitas D,et al.Accessory spleen hypertrophy mimicking colon cancer metastasis[J].Exp Oncol,2016,38(3):202-3.
[19]Wang W,Li W,Sun Y,et al.Intra-gastric Ectopic Splenic Tissue[J].J Gastrointest Surg,2016,20(1):218-20.
[20]Arra A,Ramdass MJ,Mohammed A,et al.Giant accessory rightsided suprarenal spleen in thalassaemia[J].Case Rep Pathol,2013,69(13):543-9.
[21]王丹.Douglas窝副脾误诊为淋巴瘤一例[J].中国优生与遗传杂志,2011,19(04):95-9.
[22]廉建坡,徐烈雨,陈东宁,等.罕见肾上腺区占位性病变13例分析[J].现代泌尿外科杂志,2015,20(12):848-50.
[23]郝其源,王延海.盆腔副脾误诊为子宫浆膜下肌瘤一例并文献复习[J].生物医学工程与临床,2018,22(1):80-1.
[24]Xia Z,Zhou Z,Shang Z,et al.An unusual right-sided suprarenal accessory spleen misdiagnosed as an atypical pheochromocytoma[J].Urology,2017,110(8):e1-2.
[25]吴雪松,柯阳,张成,等.罕见腹腔多发副脾1例并文献复习[J].川北医学院学报,2015,30(6):886-8.
[26]孟朗.副脾的影像诊断与误诊原因分析[C]//浙江省医学会超声医学分会.2016年浙江省超声医学学术年会论文汇编,2016.
[27]陈易人.副脾的临床意义[J].中国实用外科杂志,1999,19(12):715-7.
[28]Mohammadi S,Hedjazi A,Sajjadian M,et al.Accessory spleen in the splenic hilum:a cadaveric study with clinical significance[J].Med Archiv,2016,70(5):389-91.
[29]胡仁健,秦红军,程刚,等.腹腔镜下脾切除术的几点探讨[J].肝胆胰外科杂志,2015,27(2):143-5.
[30]Rizzuto A,Di Saverio S.Laparoscopic splenectomy for a simultaneous wandering spleen along with an ectopic accessory spleen.Case report and review of the literature[J].Int J Surg Case Rep,2018,43(5):36-40.
[2]张菁,伍兵,庄宇,等.脾脏病变CT/MRI诊断进展[J].华西医学,2017,32(10):1606-10.
[3]Wang G,Chen P,Zong L.Accessory spleen arising from the gastric fundus mimicking gastrointestinal stromal tumor following splenectomy:a case report[J].Exp Ther Med,2014,7(2):349-51.
[4]彭俊红,刘松,周利华,等.特殊副脾的CT与MRI征象[J].世界华人消化杂志,2013,21(10):925-30.
[5]Pachowicz M,Mocarska A,Staros?awska E,et al.Accessory spleen mimicking pancreatic tumour:evaluation by 99mTc-labelled colloid SPECT/CT study.Report of two cases and a review of nuclear medicine methods utility[J].Folia Morphol(Praha),2015,74(4):532-9.
[6]Xu SY,Sun K,Xie HY,et al.Accessory spleen located in the right parietal peritoneum:The first case report[J].Medicine,2017,96(38):e7957-9.
[7]Zhou JS,Hu HP,Chen YY,et al.Rare presentation of a right retroperitoneal accessory spleen:A case report[J].Oncol Lett,2015,10(4):2400-2.
[8]LüYF,Han BB,Yu HL,et al.Accessory spleen appearing as an intrasplenic pseudo-tumoral mass:A rare case report[J].Oncol Lett,2015,10(2):982-4.
[9]侯卫华.副脾误诊为左肾上腺瘤超声表现1例[J].中国医学影像技术,2015,31(1):66-9.
[10]曹佑军,龚向阳,王建.肾上腺区副脾的CT表现[J].临床放射学杂志,2016,35(2):300-3.
[11]郭宇文,王文营,宋健,等.脾切除后副脾增大表现为左肾上腺假瘤一例报告并文献复习[J].国际外科学杂志,2015,42(8):539 -40,封4.
[12]杜宁,郭卫东,王祖森,等.胰腺内副脾表皮样囊肿1例并文献复习[J].中国普通外科杂志,2015,24(3):429-34.
[13]杨勇,杨军,丁亮,等.肝异位副脾误诊为右侧肾上腺占位性病变1例报道[J].中国普外基础与临床杂志,2016,23(8):907-10.
[14]葛红军,庄园,丁红,等.右侧膈肌副脾误诊为肝脏肿瘤1例[J].中国医学影像学杂志,2016,24(8):588-90.
[15]周长青.胰腺内异位副脾一例[J].临床放射学杂志,2017,36(05):713-4.
[16]Chan KJ,Fenton-Lee D.Intrapancreatic accessory spleen masquerading as a pancreatic neuroendocrine tumor[J].JGastrointest Surg,2018,22(10):1799-800.
[17]武文杰,李晓斌,吴文铭,等.胰腺内异位副脾的诊断[J].中华胰腺病杂志,2017,17(4):285-8.
[18]Ates I,Yazici O,Yazilitas D,et al.Accessory spleen hypertrophy mimicking colon cancer metastasis[J].Exp Oncol,2016,38(3):202-3.
[19]Wang W,Li W,Sun Y,et al.Intra-gastric Ectopic Splenic Tissue[J].J Gastrointest Surg,2016,20(1):218-20.
[20]Arra A,Ramdass MJ,Mohammed A,et al.Giant accessory rightsided suprarenal spleen in thalassaemia[J].Case Rep Pathol,2013,69(13):543-9.
[21]王丹.Douglas窝副脾误诊为淋巴瘤一例[J].中国优生与遗传杂志,2011,19(04):95-9.
[22]廉建坡,徐烈雨,陈东宁,等.罕见肾上腺区占位性病变13例分析[J].现代泌尿外科杂志,2015,20(12):848-50.
[23]郝其源,王延海.盆腔副脾误诊为子宫浆膜下肌瘤一例并文献复习[J].生物医学工程与临床,2018,22(1):80-1.
[24]Xia Z,Zhou Z,Shang Z,et al.An unusual right-sided suprarenal accessory spleen misdiagnosed as an atypical pheochromocytoma[J].Urology,2017,110(8):e1-2.
[25]吴雪松,柯阳,张成,等.罕见腹腔多发副脾1例并文献复习[J].川北医学院学报,2015,30(6):886-8.
[26]孟朗.副脾的影像诊断与误诊原因分析[C]//浙江省医学会超声医学分会.2016年浙江省超声医学学术年会论文汇编,2016.
[27]陈易人.副脾的临床意义[J].中国实用外科杂志,1999,19(12):715-7.
[28]Mohammadi S,Hedjazi A,Sajjadian M,et al.Accessory spleen in the splenic hilum:a cadaveric study with clinical significance[J].Med Archiv,2016,70(5):389-91.
[29]胡仁健,秦红军,程刚,等.腹腔镜下脾切除术的几点探讨[J].肝胆胰外科杂志,2015,27(2):143-5.
[30]Rizzuto A,Di Saverio S.Laparoscopic splenectomy for a simultaneous wandering spleen along with an ectopic accessory spleen.Case report and review of the literature[J].Int J Surg Case Rep,2018,43(5):36-40.