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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 98 -100. doi: 10.3877/cma.j.issn.1674-3946.2021.01.028

所属专题: 文献

论著

直径>5 cm的真性巨大脾动脉瘤诊治分析
吴奇1, 宋勰1, 刘丙强1, 刘方峰1, 卢俊1, 常宏1,()   
  1. 1. 250000 济南,山东大学附属省立医院肝胆外科
  • 收稿日期:2020-05-01 出版日期:2021-02-10
  • 通信作者: 常宏

Clinical analysis of the diagnosis and treatment of true giant splenic artery aneurysm with a diameter of >5 cm

Qi Wu1, Xie Song1, Bingqiang Liu1, Fangfeng Liu1, Jun Lu1, Hong Chang1,()   

  1. 1. The Department of Hepatobiliary Surgery, Provincial Hospital Affiliated to Shandong University, Shandong 250000, China
  • Received:2020-05-01 Published:2021-02-10
  • Corresponding author: Hong Chang
  • Supported by:
    Key R&D Project of Shandong Province(2015GGH318017)
引用本文:

吴奇, 宋勰, 刘丙强, 刘方峰, 卢俊, 常宏. 直径>5 cm的真性巨大脾动脉瘤诊治分析[J]. 中华普外科手术学杂志(电子版), 2021, 15(01): 98-100.

Qi Wu, Xie Song, Bingqiang Liu, Fangfeng Liu, Jun Lu, Hong Chang. Clinical analysis of the diagnosis and treatment of true giant splenic artery aneurysm with a diameter of >5 cm[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(01): 98-100.

目的

探讨直径>5 cm的真性巨大脾动脉瘤的临床诊治特点。

方法

回顾性分析2013年5月至2019年11月收治的3例直径>5 cm的真性巨大脾动脉瘤患者的临床资料,并回顾相关文献。

结果

男性1例,女性2例,平均年龄60岁。腹痛、腹胀表现1例,左上腹部搏动性包块1例,查体发现1例;2例合并门脉高压症,女性患者均有2次妊娠史,1例左上腹触及搏动性包块,3例患者均行腹部强化CT检查。1例行介入支架腔内隔绝+瘤腔弹簧圈栓塞术;1例行开腹脾动脉瘤切除+脾切除术,术中出血少,未输血;1例行开腹脾动脉瘤切除+脾切除+脾静脉瘤切除+胆囊切除术,术中出血约400 ml,输注红细胞6 U,血浆600 ml。3例均治疗成功,无围术期死亡发生。介入治疗者随访2年3个月,无不适。手术者1例随访6年,预后较好,另1例失访。

结论

直径>5 cm的真性巨大脾动脉瘤罕见,具有独特的临床特征,手术切除仍是其主要且有效的治疗方法,预后较好。

Objective

To explore the clinical features of the diagnosis and treatment of true giant splenic artery aneurysm with a diameter of >5 cm.

Methods

From May 2013 to November 2019, clinical data of 3 patients with true giant splenic aneurysms with a diameter of > 5 cm, were analyzed retrospectively, meanwhile the relevant literature were also reviewed.

Results

There were 1 male and 2 female patients, with an average age of 60 years. There were 1 case of abdominal pain and distension, 1 case of pulsatile mass in the left upper abdomen and 1 case diagnosed by physical examination, including 2 cases combined with portal hypertension. All of 2 female patients had a history of two pregnancies, including one case of a pulsatile palpable in the left upper abdomen. Three patients received enhanced CT examination of the abdomen. One patient underwent interventional stent endovascular exclusion+ tumor cavity coil embolization. One patient underwent open splenic aneurysm resection+ splenectomy with less intraoperative bleeding and no blood transfusion. One patient underwent open splenic aneurysm resection+ splenectomy+ splenic vein aneurysm resection+ cholecystectomy with intraoperative bleeding of 400 mL and a transfusion of 6 U of red blood cells+ 600 mL of plasma. All 3 cases were successfully treated and no perioperative death occurred. The patient underwent interventional treatment was followed up for 2 years and 3 months without discomfort. One patient who underwent surgery was followed up for 6 years with a good prognosis, and the other was lost to follow-up.

Conclusion

True giant splenic aneurysms with a diameter of > 5 cm is rare and has unique clinical features. Surgical resection remains its main and effective treatment with a better prognosis.

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