儿童游走脾扭转并破裂出血1例报告并文献复习

A Case Report of Torsion of Wandering Spleen with Rupture and Hemorrhage in Children and Literature Review

摘要: 目的：总结儿童游走脾扭转并破裂出血的诊断及治疗特点。方法：回顾性分析1例儿童游走脾扭转并破裂出血的患儿病历资料，并进行文献复习。结果：患儿男，14岁，因“下腹部外伤3天、腹胀伴阵发性晕厥1天”入院，入院后完善检查及手术诊断为“游走脾扭转并破裂出血”，行游走脾切除术，术后病情平稳出院。通过检索中国期刊全文数据库(CNKI)、万方数据知识服务平台、PubMed数据库收录至今的文章，共检索到中文报道儿童游走脾扭转52例，英文报道儿童游走脾扭转79例；检索到中文报道成人游走脾扭转并破裂出血1例；英文报道游走脾扭转并破裂出血3例，其中成人2例，儿童1例。结论：游走脾的术前诊断存在一定困难，结合检查及临床表现，一旦怀疑游走脾扭转、破裂出血时积极手术，患儿预后一般较好。

Abstract: Objective: To summarize the characteristics of diagnosis and treatment of torsion of wandering spleen with rupture and hemorrhage in children. Methods: Analyze the medical records of a child with wandering splenic torsion, rupture and hemorrhage and review the literature. Results: The patient, a 14-year-old male, was admitted to hospital due to “lower abdominal trauma for 3 days and abdominal distension accompanied by paroxysmal syncope for 1 day”. After admission, the pa-tient was diagnosed as “wandering splenic torsion with rupture and hemorrhage” by complete ex-amination and operation. He underwent wandering splenectomy and was discharged smoothly after surgery. By searching the articles collected in CNKI, Wanfang Data Knowledge Service Platform and PubMed database, 119 cases of wandering splenic torsion infarction were retrieved in Chinese, in-cluding 67 cases of adults and 52 cases of children. 240 cases of wandering splenic torsion infarction were reported in English, of which 161 were adults and 79 were children. The Chinese report of a case of adult wandering splenic torsion with rupture and bleeding was retrieved. Three cases of splenic torsion with rupture and hemorrhage were reported in English, including 2 adult cases and 1 child case. Conclusion: The preoperative diagnosis of the wandering spleen is difficult. Combined with the examination and clinical manifestations, if the wandering spleen is suspected of torsion, rupture and bleeding, after active operation the prognosis is good.