ALTHOUGH unusual, hemangioma is the most common type of primary splenic neoplasm.1 Usually, splenic hemangioma appears as solid mass, but sometimes it presents cystic corn-ponent as well, which is difficult to discrim...ALTHOUGH unusual, hemangioma is the most common type of primary splenic neoplasm.1 Usually, splenic hemangioma appears as solid mass, but sometimes it presents cystic corn-ponent as well, which is difficult to discriminate from some other lesions, such as abscess, simple cyst, parasitic cyst, and lymphangioma.2 Preoperative diagnosis of splenic hemangioma mainly depends on imaging study （e.g. ultrasonography, CT, MRI）.展开更多
Splenic cysts are rare in pediatric surgery. They can be classified as ＂true＂ cysts or pseudocysts on the basis of the presence or absence of an epithelial lining. Congenital cysts represent 10% of splenic cysts, mo...Splenic cysts are rare in pediatric surgery. They can be classified as ＂true＂ cysts or pseudocysts on the basis of the presence or absence of an epithelial lining. Congenital cysts represent 10% of splenic cysts, most of which are epidermoid lesions. Splenectomy was initially the surgical treatment employed due to size, risk of operative complications, and fear of postoperative bleeding. With the introduction of minimally invasive surgery, several cases have been documented where laparoscopy has been used safely and with good results. The use of laparoscopy is less aggressive, resulting in less postoperative discomfort, and requires a shorter stay in the hospital and with the same results as with the open approacht. We report a new case of congenital splenic cyst handled successfully by laparoscopy including a follow-up period of more than 2 years.展开更多
Background: Splenic cysts are infrequent findings in everyday medical practice. They are usually associated with nonspecific symptoms and the diagnosis is incidental. In most instances they are located in the left sub...Background: Splenic cysts are infrequent findings in everyday medical practice. They are usually associated with nonspecific symptoms and the diagnosis is incidental. In most instances they are located in the left subcostal region, except for cases of huge sized cysts which can extend to the whole abdomen or pelvis. Aim: To present a case of a large hypogastric splenic cyst in a nulliparous woman, managed with robotic cystectomy. Review of the literature is included. Case: A 19-year-old woman, presented to the gynecologic department with a painless, palpable mass in the lower abdomen. Ultrasonography revealed a pelvic cystic mass, originally misdiagnosed for an ovarian cyst. Serum biomarkers and?β-hCG were negative. Definite diagnosis was made during explorative laparoscopy where the cyst was found to originate from the spleen. The surgery setup was changed from a lower to upper abdominal procedure. A robotically-assisted cystectomy was performed without concurrent splenectomy, and the splenic cavity was filled with an omental patch. There was no blood loss and the operation time was 163 minutes. Recovery was uneventful and there was no recurrence for a period of 16 months postoperatively. Conclusions: Pelvic splenic cysts are rare, and may be incidental findings during routine abdominal ultrasound scans. Modern minimally invasive approaches such as robotic surgery offer safe and efficient alternatives to standard techniques.展开更多
BACKGROUND Robotic-assisted partial splenectomy(RAPS)is a superior approach for treating splenic cysts and splenic hemangiomas,as it preserves the immune function of the spleen and reduces the risk of overwhelming pos...BACKGROUND Robotic-assisted partial splenectomy(RAPS)is a superior approach for treating splenic cysts and splenic hemangiomas,as it preserves the immune function of the spleen and reduces the risk of overwhelming post splenectomy infection.Curren-tly,there are no standardized guidelines for performing a partial splenectomy.CASE SUMMARY Four patients with splenic cysts or splenic hemangiomas were treated by RAPS.Critical aspects with RAPS include carefully dissecting the splenic pedicle,accurately identifying and ligating the supplying vessels of the targeted segment,and ensuring precise hemostasis during splenic parenchymal transection.Four successful RAPS cases are presented,where the tumors were removed by pret-reating the splenic artery,dissecting and ligating the corresponding segmental vessels of the splenic pedicle,transecting the ischemic segment of the spleen,and using electrocautery for optimal hemostasis.Four patients underwent successful surgeries with minimal bleeding during the procedure,and there were no signs of bleeding or recurrence postoperatively.CONCLUSION Four cases confirm the feasibility and superiority of RAPS for the treatment of benign splenic tumors.展开更多
Splenic cysts are unusual in daily surgical practice and less than 1000 cases have been reported. Primary, true or epithelial splenic cysts, are even rarer. Usually, most of the cysts are asymptomatic until of signifi...Splenic cysts are unusual in daily surgical practice and less than 1000 cases have been reported. Primary, true or epithelial splenic cysts, are even rarer. Usually, most of the cysts are asymptomatic until of significant size, at which time they are then detected incidentally on ultrasonography or CT scan. We report a case of a 25-year-old woman with giant epithelial splenic cyst with about 3000 ml of clear-yellow fluid was collected from the cyst. The splenectomy specimen measured 205 mmx192 mmx137 mm and weighed 4000 g.展开更多
1 病例资料
患者男性，43岁，主因“腹痛、气紧、乏力2个月余”入院。病史：患者缘于20余天前无明显诱因出现中上腹隐痛于外院住院治疗，诊断为“急性胰腺炎、高血压、糖尿病”，给予相应治疗（具体不详），之后出现间断发热，经抗...1 病例资料
患者男性，43岁，主因“腹痛、气紧、乏力2个月余”入院。病史：患者缘于20余天前无明显诱因出现中上腹隐痛于外院住院治疗，诊断为“急性胰腺炎、高血压、糖尿病”，给予相应治疗（具体不详），之后出现间断发热，经抗生素及对症治疗后好转，12 d 后患者出现高热，最高达39．7℃，自觉气促、心跳加快，磁共振胰胆管造影提示胆囊增大，遂转入本院治疗。入院后给予泰能抗感染、胆囊穿刺引流、胸腹腔穿刺引流，对症及支持治疗后上述症状有所好转，后自行要求出院。出院后，仍间断发热、腹痛，遂再次入院。查体：神清，精神差，腹部膨隆，中上腹、左上腹及中下腹可见3条引流管，腹软，全腹无压痛、反跳痛及肌紧张，肝脾肋下未及，肝脾肾区无叩痛，肠鸣音约3次／min，移动性浊音阴性，双下肢无水肿。查血常规示：白细胞计数8．44×109／L，红细胞计数2．98×1012／L↓，血红蛋白浓度84 g／L↓，中性粒细胞比率81．51％↑；血生化：肌酐41．30μmol／L↓，葡萄糖7．21 mmol／L↑，GGT 126．00 U ／L↑，ALP 197．10 U ／L↑，降钙素原＜0．05 ng／ml；尿常规：隐血（＋）↑。余肝肾功能、电解质未见异常。查腹部 CT 示：急性坏死性胰腺炎治疗后改变，腹腔积液引流术后，胰腺体见一5．7 cm ×2．7 cm 大小脓肿，邻近脾静脉、门静脉主干，肠系膜上静脉上段稍显狭窄，周围结构显示不清，侧枝血管形成，食管胃底静脉曲张（图1）。胃镜检查示：胃底见团块状静脉曲张，无红色征；胃底、胃体广泛黏膜肿胀，诊断为：（1）胃底重度静脉曲张（无红色征）；（2）门静脉高压性胃病（图2）。展开更多
文摘ALTHOUGH unusual, hemangioma is the most common type of primary splenic neoplasm.1 Usually, splenic hemangioma appears as solid mass, but sometimes it presents cystic corn-ponent as well, which is difficult to discriminate from some other lesions, such as abscess, simple cyst, parasitic cyst, and lymphangioma.2 Preoperative diagnosis of splenic hemangioma mainly depends on imaging study （e.g. ultrasonography, CT, MRI）.
文摘Splenic cysts are rare in pediatric surgery. They can be classified as ＂true＂ cysts or pseudocysts on the basis of the presence or absence of an epithelial lining. Congenital cysts represent 10% of splenic cysts, most of which are epidermoid lesions. Splenectomy was initially the surgical treatment employed due to size, risk of operative complications, and fear of postoperative bleeding. With the introduction of minimally invasive surgery, several cases have been documented where laparoscopy has been used safely and with good results. The use of laparoscopy is less aggressive, resulting in less postoperative discomfort, and requires a shorter stay in the hospital and with the same results as with the open approacht. We report a new case of congenital splenic cyst handled successfully by laparoscopy including a follow-up period of more than 2 years.
文摘Background: Splenic cysts are infrequent findings in everyday medical practice. They are usually associated with nonspecific symptoms and the diagnosis is incidental. In most instances they are located in the left subcostal region, except for cases of huge sized cysts which can extend to the whole abdomen or pelvis. Aim: To present a case of a large hypogastric splenic cyst in a nulliparous woman, managed with robotic cystectomy. Review of the literature is included. Case: A 19-year-old woman, presented to the gynecologic department with a painless, palpable mass in the lower abdomen. Ultrasonography revealed a pelvic cystic mass, originally misdiagnosed for an ovarian cyst. Serum biomarkers and?β-hCG were negative. Definite diagnosis was made during explorative laparoscopy where the cyst was found to originate from the spleen. The surgery setup was changed from a lower to upper abdominal procedure. A robotically-assisted cystectomy was performed without concurrent splenectomy, and the splenic cavity was filled with an omental patch. There was no blood loss and the operation time was 163 minutes. Recovery was uneventful and there was no recurrence for a period of 16 months postoperatively. Conclusions: Pelvic splenic cysts are rare, and may be incidental findings during routine abdominal ultrasound scans. Modern minimally invasive approaches such as robotic surgery offer safe and efficient alternatives to standard techniques.
基金Supported by Nantong“14th Five-Year”Science and Education to Strengthen Health Project,General Surgery Medical Key Discipline,No.42.
文摘BACKGROUND Robotic-assisted partial splenectomy(RAPS)is a superior approach for treating splenic cysts and splenic hemangiomas,as it preserves the immune function of the spleen and reduces the risk of overwhelming post splenectomy infection.Curren-tly,there are no standardized guidelines for performing a partial splenectomy.CASE SUMMARY Four patients with splenic cysts or splenic hemangiomas were treated by RAPS.Critical aspects with RAPS include carefully dissecting the splenic pedicle,accurately identifying and ligating the supplying vessels of the targeted segment,and ensuring precise hemostasis during splenic parenchymal transection.Four successful RAPS cases are presented,where the tumors were removed by pret-reating the splenic artery,dissecting and ligating the corresponding segmental vessels of the splenic pedicle,transecting the ischemic segment of the spleen,and using electrocautery for optimal hemostasis.Four patients underwent successful surgeries with minimal bleeding during the procedure,and there were no signs of bleeding or recurrence postoperatively.CONCLUSION Four cases confirm the feasibility and superiority of RAPS for the treatment of benign splenic tumors.
文摘Splenic cysts are unusual in daily surgical practice and less than 1000 cases have been reported. Primary, true or epithelial splenic cysts, are even rarer. Usually, most of the cysts are asymptomatic until of significant size, at which time they are then detected incidentally on ultrasonography or CT scan. We report a case of a 25-year-old woman with giant epithelial splenic cyst with about 3000 ml of clear-yellow fluid was collected from the cyst. The splenectomy specimen measured 205 mmx192 mmx137 mm and weighed 4000 g.
文摘1 病例资料
患者男性，43岁，主因“腹痛、气紧、乏力2个月余”入院。病史：患者缘于20余天前无明显诱因出现中上腹隐痛于外院住院治疗，诊断为“急性胰腺炎、高血压、糖尿病”，给予相应治疗（具体不详），之后出现间断发热，经抗生素及对症治疗后好转，12 d 后患者出现高热，最高达39．7℃，自觉气促、心跳加快，磁共振胰胆管造影提示胆囊增大，遂转入本院治疗。入院后给予泰能抗感染、胆囊穿刺引流、胸腹腔穿刺引流，对症及支持治疗后上述症状有所好转，后自行要求出院。出院后，仍间断发热、腹痛，遂再次入院。查体：神清，精神差，腹部膨隆，中上腹、左上腹及中下腹可见3条引流管，腹软，全腹无压痛、反跳痛及肌紧张，肝脾肋下未及，肝脾肾区无叩痛，肠鸣音约3次／min，移动性浊音阴性，双下肢无水肿。查血常规示：白细胞计数8．44×109／L，红细胞计数2．98×1012／L↓，血红蛋白浓度84 g／L↓，中性粒细胞比率81．51％↑；血生化：肌酐41．30μmol／L↓，葡萄糖7．21 mmol／L↑，GGT 126．00 U ／L↑，ALP 197．10 U ／L↑，降钙素原＜0．05 ng／ml；尿常规：隐血（＋）↑。余肝肾功能、电解质未见异常。查腹部 CT 示：急性坏死性胰腺炎治疗后改变，腹腔积液引流术后，胰腺体见一5．7 cm ×2．7 cm 大小脓肿，邻近脾静脉、门静脉主干，肠系膜上静脉上段稍显狭窄，周围结构显示不清，侧枝血管形成，食管胃底静脉曲张（图1）。胃镜检查示：胃底见团块状静脉曲张，无红色征；胃底、胃体广泛黏膜肿胀，诊断为：（1）胃底重度静脉曲张（无红色征）；（2）门静脉高压性胃病（图2）。
